Gonadotropin-Releasing Hormone (GnRH)/GnRH Receptors and Their Role in the Treatment of Endometriosis.

Endometriosis, defined as the development of endometrial tissue outside of the uterine cavity, is a common gynecological disorder. The prevalence of pelvic endometriosis approaches 6%-10% in the general female population, and in women with pain, infertility, or both, the frequency is 35%-50%. The gold standard recommended process for diagnosing endometriosis is laparoscopy, an invasive surgical procedure, with or without histologic verification. The currently available nonsurgical treatments include oral contraceptives (estrogen-progestogen preparations), progestogen preparations (containing progesterone derivatives), androgenic hormones (danazol), and gonadotropin-releasing hormone (GnRH) agonists and antagonists. Two GnRH types have been discovered in mammals, GnRH I and GnRH II. In particular, GnRH I is released by the hypothalamus; however, it can be present in various tissues and organs of the body, including neural tissue, where it exerts neuroendocrine, autocrine, and paracrine actions in the peripheral and central nervous system (CNS). Interestingly, another GnRH isoform, GnRH III, has been identified, which has 60% similarity with GnRH I from which it varies by four amino acids. This peptide has been shown to have a significant role in reproduction, specifically in gametogenesis and steroidogenesis. Further research is needed to identify innovative treatment options for endometriosis, such as the therapeutic exogenous administration of GnRH II or antagonists of the GnRH I receptor. In this review, we examined the role of GnRH in endometriosis, outlining the specific actions of GnRH and GnRH receptors (GnRHRs). The innovative use of GnRH analogs and antagonists in the treatment of endometriosis is also discussed.

Unilateral Duplicated Collecting System Identified During Pelvic Lymphadenectomy: A Case Report and Literature Review.

Anatomic variations can be an additional challenge for any surgeon, especially in complicated surgical procedures, and they could lead to complications if not identified timely. We present a case report of an incidental intraoperative finding of unilateral duplicated ureter, identified during pelvic lymphadenectomy for a patient who underwent surgical treatment for ovarian cancer. Also, we include an update on this anatomic variation following the literature review. The importance of a systematic approach in the identification of the relevant anatomy and landmarks, taking into consideration the variation of the duplicated ureter, is emphasized in this paper and may contribute beneficially to the experience of surgeons operating in this field.

Anatomical Variations of Vascular Anatomy in Meckel's Diverticulum.

OBJECTIVE: The objective of the current study was to describe the anatomical variations of vessels observed in patients with Meckel's Diverticulum. METHODS: A narrative review of the literature was undertaken by means of the PubMed database, using the terms: "Meckel's Diverticulum AND vessels", "Meckel's Diverticulum AND anatomical variation" and "Meckel's Diverticulum variation". Classical anatomical textbooks were also used for normal anatomy. Additional articles provided useful information in relation to the aim of this review. Hence, the articles that met the inclusion criteria were included in this review, and the collected data were categorized into a single table. RESULTS: The majority of studies indicated the presence of an abnormal vitelline artery. Other angiographic findings concerned variations of the ileal and the iliac arteries. However, the literature revealed the presence of vascular variations without the existence of Meckel's Diverticulum, whereas a remnant of the vitelline vein may be present, but it is very rare. CONCLUSION: The detection of vascular variations accompanying Meckel's Diverticulum is not always easy and requires the correct choice of imaging method to prevent misdiagnosis.

Ectopic Pregnancy in a Levonogestrel-Releasing Intrauterine Device User: A Case Report.

Levonorgestrel-releasing intrauterine devices are considered to be a reliable contraceptive option with a low failure rate. The risk of ectopic pregnancy, however, if an unintended pregnancy occurs is significantly higher. In this study, we present a case of a tubal ectopic pregnancy in a woman with a levonorgestrel-releasing intrauterine device in situ for one year. Our case emphasises the importance of having a high index of suspicion in women who have an intrauterine device in situ, presenting with a positive pregnancy test. We also discuss the importance of timely ultrasound examination and the management considerations of similar cases. The importance of urgent review and investigation of women with positive pregnancy test and intrauterine contraceptive device in situ, given the higher possibility of ectopic pregnancy, is highlighted by this case.