Ectopic pregnancy, that is, a blastocyst occurring outside the endometrial cavity of the uterus, affects nearly 2% of pregnancies. The treatment of ectopic pregnancy is surgical or pharmacological. Since surgical management is associated with numerous serious side effects, conservative treatment is sought. The treatment of choice in the majority of cases is based on pharmacotherapy with methotrexate (MTX) in a single- or multi-dose regimen. Although the efficacy of methotrexate reaches between 70 and 90%, its use requires specific conditions regarding both the general condition of the patient and the characteristic features of the ectopic pregnancy. Moreover, MTX can cause severe adverse effects, including stomatitis, hepatotoxicity and myelosuppression. Therefore, clinicians and researchers are still looking for a less toxic, more effective treatment, which could prevent surgeries as a second-choice treatment. Some studies indicate that other substances might constitute a good alternative to methotrexate in the management of ectopic pregnancies. These substances include aromatase inhibitors, especially letrozole. Another promising substance in EP treatment is gefitinib, an inhibitor of EGFR tyrosine domain which, combined with MTX, seems to constitute a more effective alternative in the management of tubal ectopic pregnancies. Other substances for local administration include KCl and absolute ethanol. KCl injections used in combination with MTX may be used when foetal heart function is detected in cervical ectopic pregnancies, as well as in heterotopic pregnancy treatment. Absolute ethanol injections proved successful and safe in caesarean scar pregnancies management. Thus far, little is known about the use of those substances in the treatment of ectopic pregnancies, but already conducted studies seem to be promising.

Patients with Parkinson’s disease (PD) have an increased risk of melanoma compared with the general population. Considering that Nonmelanoma Skin Cancers (NMSCs) share similar risk factors with melanoma, there is a need to understand a possible connection between PD and NMSCs. The aim of the study was the evaluation of NMSC risk among PD patients via meta-analysis and systematic review. A comprehensive search of PubMed, Scopus, and Web of Science databases was conducted, including studies from January 2000 to April 2020. We identified 16 eligible studies including 140291 PD patients. Upon statistical analysis, a significantly higher risk of developing NMSCs in PD patients was found compared with the control group (odds ratio (OR) = 1.25, 95% CI: 1.17–1.33; p < 0.0001). Among all NMSCs, the risk of developing basal cell carcinoma in PD patients was significantly higher (OR = 1.30, 95% confidence interval (CI): 1.15–1.47; p < 0.0001), contrary to squamous cell carcinoma. Further analysis revealed a significantly higher risk of developing NMSCs in patients with previously diagnosed PD (OR = 1.26, 95% CI: 1.19–1.33; p < 0.0001). Our data suggest the necessity for regular skin examination of PD patients, though further studies are required to explore the mechanisms forming this relationship.

Introduction and purpose: The problem with infertility affects between 8 and 12% of reproductive-aged couples. Among the reasons, smoking, adulterated food, hormonal disorder are featured. Our purpose is to check how micronutrients impact fertility.Brief description of the state of knowledge: Micronutrients deficiency, specifically zinc and selenium deficiencies have also unpropitious impact on fertility. In this review, the potential role of these microelements in male and female reproductive health is considered. Zinc had been proved to regulate sperm motility, spermatogenesis and reduce oxidative stress. Lower delivery of selenium decrease testosterone level by causing changes in receptor of the luteinising hormone. It is also compared with lower spermatozoa concentration. In this review the role of iron, manganese, lead, nickel, copper, magnesium and cobalt is described as well. Summary: Deficiencies of some micronutrients may make worse the fertility. That’s the reason why additional supplementation may be important in the treatment of infertility.

Introduction and purpose: Postpartum depression (PPD) is one of the most common conditions in childbearing. It is estimated that 10-15% of mothers develop PPD. Oxytocin has recently been implicated in the pathophysiology of several neuropsychiatric disorders including PPD. The aim of this study is to, on the base of recent studies, investigate whether oxytocin has an impact on PPD and if it can be used as a way of diagnostic indicator or treatment. Brief description of the state of knowledgement: Studies indicate that there is a relationship between oxytocin and PPD. Depression and anxiety after delivery were observed more frequently among women with lower oxytocin plasma levels. Basing on the oxytocin plasma levels in the third semester of pregnancy, the risk of PPD can be predicted. This relationship was observed in women who were breastfeeding as well as in those who cessed. Some studies indicate that depression development may be inhibited thanks to oxytocin. Exogenous oxytocin has been proven to improve prosocial behaviour and reduce negative emotional responses in mother-children relations. It may also increase mother’s attention to baby. Some studies have stated that intrapartum oxytocin administration decreases the rate of PPD symptoms but studies on treatment with oxytocin are not unanimous. Conclusions: Oxytocin plays an undeniable role in pathophysiology of postpartum depression and it may be regarded as a diagnostic indicator and therapeutic target. However, more studies are needed to clarify this intricate relationship.

Background: Endometrial cancer is the most common gynecological malignant neoplasm, which occurs in the majority of cases postmenopausally. The current standard of treatment is surgical - total hysterectomy. However, it may also occur in younger patients, who are planning pregnancy and want to choose fertility-sparing treatment. For those patients oral high dose progestin therapy with or without hysteroscopic resection should be proposed. It is usually a good option for women with well-differentiated (G1) cancers. For patients with higher grade (G2, G3) or contraindications to progestins, fertility-sparing treatment of endometrial cancer seems impossible. Case report: We present the case of a 34-year old woman diagnosed gynecologically due to abnormal bleeding from the genital tract. Based on USG, she was diagnosed with endometrial polyp. As a treatment, hysteroscopic resection was performed. In the histopathological evaluation G2 endometrial cancer was diagnosed. The standard approach would be a total hysterectomy, but the patient was interested in fertility-sparing options. Due to contraindications to progestins a total hysteroscopic resection was performed counseling the patient about the risks of a novel approach. Histopathology revealed no residual disease and no other lesions during the first year of observations occurred. Conclusion: Total hysteroscopic resection without further progestin therapy may offer the possibility to treat G2 endometrial cancer despite contraindications to the administration of progestins. Our case report should also encourage further evaluation of fertility-sparing management of endometrial cancer with higher than G1 grade.

Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown etiology. An important role in the pathogenesis of SLE has been attributed to interferon alpha (IFN-α), which stimulates the expression of numerous genes, resulting in an increased autoinflammatory response. Recent studies have demonstrated increased levels of this cytokine in patients with SLE, as well as in relatives, indicating that IFN- α is an inherited risk factor for lupus. Cases of induction of SLE/lupus-like syndrome after IFN- α therapy also point to the involvement of interferon in the pathogenesis of the disease. Interferon being a probable initiator of the disease, as well as a marker to examine its exacerbations, is a potential research target to better understand the etiology and pathogenesis of lupus. More research is needed to determine the feasibility of using INF-blocking agents for new therapies in SLE.