When and How to Utilize Pudendal Nerve Blocks for Treatment of Pudendal Neuralgia.

Chronic pelvic pain is a common cause of pain in reproductive age women with debilitating consequences for affected women's health and quality of life. Treatment providers must be well versed in all treatment options for these patients, understanding the overlap in the management and treatment of chronic pelvic pain caused by pudendal neuralgia, myofascial pelvic pain, and vulvodynia. Pudendal blocks are a simple and quick procedure that can be performed in the office and often helps improve all the above conditions when used along with other treatment options. We review the anatomy and methodology on when and how to perform pudendal blocks in the office to better inform the general gynecologist on how to implement offering this treatment in the outpatient clinical setting.

Pulmonary arterial venous malformations as primary manifestation of gestational trophoblastic neoplasia.

•A unique initial presentation of GTN as pulmonary arteriovenous malformations.•Metastatic GTN presenting as multiple visceral AVMs in the brain, liver, and lungs.•Management of metastatic GTN with brain metastases with induction chemotherapy.

Paraneoplastic cerebellar degeneration heralding recurrence of fallopian tube adenocarcinoma: A case report and literature review.

•Paraneoplastic cerebellar degeneration in recurrence of fallopian tube cancer.•Describes the initial symptoms of paraneoplastic cerebellar degeneration.•Identify a diagnosis that can lead to rapid irreversible deterioration.•Describe management and outcomes of paraneoplastic cerebellar degeneration.

Antifungal activity of camptothecin, trifolin, and hyperoside isolated from Camptotheca acuminata.

Leaf spots and root rots are major fungal diseases in Camptotheca acuminata that limit cultivation of the plant for camptothecin (CPT), a promising anticancer and antiviral alkaloid. Bioassays showed that pure CPT and flavonoids (trifolin and hyperoside) isolated from Camptotheca effectively control fungal pathogens in vitro, including Alternaria alternata, Epicoccum nigrum, Pestalotia guepinii, Drechslera sp., and Fusarium avenaceum, although antifungal activity of these compounds in the plant is limited. CPT inhibited mycelial growth by approximately 50% (EC50) at 10-30 microg/mL and fully inhibited growth at 75-125 microg/mL. The flavonoids were less effective than CPT at 50 microg/mL, particularly within 20 days after treatment, but more effective at 100 or 150 microg/mL. CPT, trifolin, and hyperoside may serve as leads for the development of fungicides.