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New prevention strategies are urgently needed to slow the spread of the HIV/AIDS pandemic, and in the absence of an effective vaccine, there is hope that "microbicides"-HIV inhibitors applied to mucosal surfaces before sexual intercourse-may be able to make an impact. Because developing countries are at the center of the epidemic, affordability and stability during storage are key criteria for candidate microbicides. Furthermore, because formulation strategies that provide long-duration protection after a single dose may enhance acceptability and compliance, stability in the vaginal environment and in the presence of semen should also be considered. PSC-RANTES, a human chemokine analog, has shown promise as a candidate microbicide, but because it contains nonnatural structures that necessitate chemical synthesis steps, it is not suitable for production at a feasible cost and scale for general distribution in developing countries. We have recently developed 2 new fully recombinant chemokine analogs, 5P12-RANTES and 6P4-RANTES, which show equivalent anti-HIV activity to PSC-RANTES. In this study, we tested the stability of these molecules under conditions related to use as microbicides. Our results suggest that stability issues will not present a major obstacle to the further development of these promising molecules as microbicides.

Background: Laparoendoscopic single-site surgery (LESS) is becoming increasingly popular in different disciplines. Evidence is scarce about its utility in gynecologic surgery. Aim: To compare our initial experience using LESS for benign adnexal disease to traditional laparoscopy. Methods: Since November 2008, we have performed LESS in 28 patients diagnosed with benign adnexal disease (group I). Patients with adnexal masses and a body mass index <35 were selected. An age-matched control group of patients with similar diagnoses who underwent traditional operative laparoscopy was included (n = 50; group II). Results: Both groups were comparable with regard to age, body mass index, preoperative diagnosis, indication of surgery and history of previous abdominal surgery. The operative blood loss ranged from minimal to <50 ml for both groups. The mean ± SD duration of surgery in group I (45 ± 19.5 min) was comparable to that of group II (46.4 ± 18.3 min). The duration of hospital stay was <24 h in both groups. Minimal use of postoperative narcotics was required in study subjects and no intraoperative complications occurred. Conclusions: LESS for benign adnexal disease is feasible in patients with or without previous surgery and is comparable to traditional laparoscopic surgery. Additional investigation is needed to evaluate the safety, cost-effectiveness and long-term outcomes of this new approach.

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Type I hypersensitivity reactions to intravenous administration of etoposide are extremely rare. Etoposide is an essential component of several chemotherapy regimens used in gynecologic oncology, and discontinuation of this drug during a course of treatment should only be due to severe patient intolerance. We report the successful use of intravenous etoposide phosphate as a substitute drug in a patient with a yolk sac tumor who manifested a Type I hypersensitivity to intravenous etoposide. The patient ultimately completed all 4 cycles of bleomycin, etoposide, cisplatin (BEP) using etoposide phosphate as a substitute drug.