In patients with stable coronary artery disease, it remains unclear whether an initial
management strategy of percutaneous coronary intervention (PCI) with intensive
pharmacologic therapy and lifestyle intervention (optimal medical therapy) is superior
to optimal medical therapy alone in reducing the risk of cardiovascular events.
We conducted a randomized trial involving 2287 patients who had objective evidence
of myocardial ischemia and significant coronary artery disease at 50 U.S. and Canadian
Over the past decade, treatment of neovascular
age-related macular degeneration has evolved
from overall retinal ablation to more targeted and
retinal-sparing therapy, beginning with the advent
of photodynamic therapy and continuing with the
development of inhibitors to vascular endothelial
growth factor (VEGF). This article summarizes the
key clinical trials with photodynamic and anti-
VEGF therapies to provide insight into and a
framework around which we can choose the optimal
treatments (including dosing) for our patients....
d-Amino acid oxidase (DAAO) has recently become of interest as a biocat-alyst for industrial applications and for therapeutic treatments. It has been
used in gene-directed enzyme prodrug therapies, in which its production of
H2O2 in tumor cells can be regulated by administration of substrate. This
approach is limited by the locally low O2 concentration and the high Km
for this substrate.
Therefore, there is a critical window of
opportunity to prevent under-nutrition – while
the mother is pregnant and during child’s first
two years of life – when proven nutrition
interventions offer children the best chance to
survive and reach optimal growth and
development; after that window closes, the
damage to children is largely irreparable.
Upper respiratory tract infections and, especially, sinusitis are frequently
encountered in the day-to-day practice of infectious disease specialists, allergists,
pediatricians, otolaryngologists, internists, and family practitioners.
The range of causative agents and available therapies and the constantly
changing spectrum of antibiotic resistance can make it difficult to select
the most appropriate course of treatment.
Acute emergencies in gastroenterology are extraordinarily
severe conditions with high morbidity and mortality.
Particularly severe diseases include acute pancreatitis,
a difficult course of non-specific intestinal inflammations
manifested by toxic colon or acute intestinal obstruction,
and even acutely developed intestinal pseudo-obstruction
(Ogilvie’s syndrome) or variceal and non-variceal bleeding
into the gastrointestinal tract.
transport limitation in larger tissue may also affect survival. Due to the macroscopic size of
tissue-engineered products and its finite thermal conductivity, there may be large thermal
gradients from the surface to the interior of the samples. The presence of a thermal gradient
during cooling and warming phases makes it difficult to choose optimal temperature
change protocols for both surface and interior cells. Moreover, osmotic effects (water
movement from inside-unfrozen cells to outside-frozen cells) during cooling, reduces cell
The physician is greatly challenged to provide optimal therapy for
mycobacterial illnesses because of the increase in both drug-susceptible and
multidrug-resistant tuberculosis; the increasing number of pathogenic
nontuberculous mycobacteria (NTM); drug-related toxicities and drug-drug
interactions (especially in patients who have AIDS, with their complex
antiretroviral drug regimens); and the plethora of new antibiotics with
The field of antiviral therapy—both the number of antiviral drugs and our understanding of their optimal use—continues to lag behind the field of antibacterial drug treatment, in which 70 years of experience have now been accumulated, but significant progress has been made in recent years on new drugs for several viral infections. The development of antiviral drugs poses several challenges. Viruses replicate intracellularly and often employ host cell enzymes, macromolecules, and organelles for synthesis of viral particles.
A similar effort may well be in order
targeting the gay and bisexual men who are
most at risk, particularly those who are living
with HIV. Further research is needed to
determine the prevalence and incidence of
ASIL in the general population of gay and
bisexual men outside of major urban centers.
Programs are needed to train colposcopists
in the skills of identifying and biopsying
ASIL; training of colorectal surgeons is
needed to optimize identification and treat-
ment of ASIL.