July 17, 2003
July 17, 2003
Finasteride and the Development of Prostate Cancer |
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Mite-Allergen Control and Allergen-Impermeable Bed Covers for Asthma Patients with asthma are commonly sensitized to house-dust-mite allergen; the microscopic creatures that produce this allergen live in bedding. The use of dust-mite–impermeable covers for bedding has been advocated as a way to prevent exacerbations of asthma. In this study involving more than 1100 adult patients with mild asthma, the use of allergen-impermeable bedding had no effect on airflow rates as compared with the use of bed covers that were not impermeable to allergen. The use of mattress and pillow covers that are impervious to house-dust mites need not be included in allergen-control measures.
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Evaluation of Impermeable Bedding Covers in Allergic Rhinitis Patients with allergic rhinitis are often instructed to avoid allergens as a way of preventing symptoms. This study examined a common intervention used to avoid allergens — encasing pillows, mattresses, and duvets in house-dust-mite–proof covers — as a specific part of an allergen-avoidance program. The use of these coverings had no effect on the symptoms of rhinitis. As an allergen-avoidance intervention, the use of mite-proof covers is expensive but simple to implement. Unfortunately, the money spent on these covers appears to provide no benefit.
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Microsatellite Instability and Benefit from Fluorouracil Therapy for Colon Cancer In some colorectal cancers, a loss of DNA-repair function causes a defect called microsatellite instability. This study unexpectedly found that adjuvant treatment with fluorouracil did not benefit patients whose tumors had high-frequency microsatellite instability, whereas such treatment did benefit patients with microsatellite-stable tumors. Patients whose tumors have microsatellite instability live longer than patients with microsatellite-stable tumors. It is unclear why fluorouracil, which can damage DNA, does not have an enhanced effect in tumors with a predisposition to genomic instability. The results of this study are not ready for clinical application but could be taken into consideration in future trials of adjuvant therapy for colorectal cancer.
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Acute Uncomplicated Urinary Tract Infection in Women A 28-year-old woman telephones her physician to report dysuria and urinary urgency during the preceding three days. She has had several previous urinary tract infections, including three during the past year. She is otherwise healthy, takes no medications, and is sexually active, using spermicide-coated condoms for contraception. She does not have fever, chills, vaginal discharge, or flank pain. How should she be evaluated and treated?
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Medical Progress: Prometheus's Vulture and the Stem-Cell Promise Embryonic stem cells have been the focus of intense study over the past two decades. Embryonic stem cells originate from undetermined early embryos, with no possible history of differentiation, whereas the provenance of adult stem cells found in mature tissues is far less well understood. The possibility that a population of reserve stem cells, perhaps set aside during gestation, might be coerced into renewed regenerative service later in life holds great promise. This review considers the status of stem-cell research.
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Mechanisms of Disease: Nuclear Transplantation, Embryonic Stem Cells, and the Potential for Cell Therapy This review discusses the difference between reproductive cloning and therapeutic cloning. It explains why reproductive cloning is impractical, whereas therapeutic cloning holds promise for the treatment of genetic and degenerative diseases.
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