Treatment of alcoholism

Article Abstract:

In the 50 years since the repeal of Prohibition, there has been growing acceptance that alcoholism is a disease. Biomedical research has been undertaken to develop greater understanding, more effective treatment therapies and prevention measures. The severity of symptoms of withdrawal from alcohol is an important indicator of the degree of physical dependence, and therefore of the risk of death and physical deterioration that will follow if the disease is not treated. Symptoms underscoring the need for immediate treatment characterize the syndrome known as delirium tremens ("DTs"), which involves tremor ("the shakes"), fever, convulsion, and hallucinatory delirium. Current standard treatment (detoxification) includes elimination of alcohol consumption, hospitalization, improved nutrition, and use of antianxiety drugs, benzodiazepines. Recent reports have indicated that treatment of mild to moderate forms of alcoholism can be successful on an outpatient basis, but there has been less agreement concerning long-term treatment of severe alcoholism, which must be considered a chronic disease. Treatments currently available are unable to cure alcoholism, but rather promote social and personal rehabilitation by prolonging the remission period. A number of questions regarding proper treatment of alcoholism remain, including those about hospitalization and rehabilitation, the importance of total abstinence, and the role of drug therapy with mood altering drugs and aversive agents such as Antabuse. In addition, the occurrence of psychiatric problems (comorbidity) with alcoholism needs further study. There is little prospect of a breakthrough in treatment; in the meantime, existing treatments must be reevaluated to assess their effectiveness, safety, and cost.

Alcoholism, Alcoholism treatment, editorial

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Endometriosis

Article Abstract:

Endometriosis is characterized by the presence of endometrial tissue outside the uterus. It most likely occurs through retrograde menstruation, since it is found almost exclusively in menstruating women. It is estimated to occur in 10% of these women. Pelvic pain is the most common symptom. Laparoscopy is the most useful diagnostic tool, but ultrasound and magnetic resonance imaging (MRI) can also be effective. The endometrial tissue is still responsive to hormones, and most treatments are aimed at reducing that response. Most of the effective treatments also reduce pelvic pain. Danazol is a drug similar to testosterone that suppresses ovulation, but it has masculinizing side effects. Derivatives of progesterone that cause the endometrial tissue to atrophy are also effective. Gonadotropin-releasing hormone derivatives can also cause atrophy of endometrial tissue. Surgery is another effective treatment, especially for advanced disease. However, many of these treatments can not correct infertility, a common complication of endometriosis.

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Treatment of endometriosis

Article Abstract:

Endometriosis can be treated with NSAIDs, oral contraceptives, drugs that mimic the action of gonadotropin-releasing hormone, and surgery. Endometriosis occurs when menstrual blood flows backward, through the Fallopian tubes and out into the pelvic cavity.

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