Summer heat waves cause thousands of cases of heat-related illness in the US each year and hundreds of heat-related deaths, especially among the elderly. This review describes the contributing factors, clinical signs, and ways to prevent and treat heat injury.

High plasma homocysteine concentrations, like high cholesterol, have been associated with an increased risk of cardiovascular disease and death (O Nygσrd et al, N Engl J Med 1997; 337:230; RS Vasan et al, JAMA 2003; 289:1251). In one meta-analysis, 25% lower plasma homocysteine concentrations were associated with 11% less coronary heart disease and 19% less stroke (Homocysteine Studies Collaboration, JAMA 2002; 288:2015). Should we be trying to lower serum homocysteine concentrations in our patients?

Bexxar, a combination of the monoclonal antibody tositumomab and radiolabeled Iodine-131 tositumomab (Corixa Corp/GlaxoSmithKline) has been approved by the FDA for a single treatment of relapsed follicular non-Hodgkin's lymphoma (NHL) in patients who are refractory to rituximab (Rituxan - Medical Letter 1998; 40:65). It is the second radioimmunoconjugate to be approved for refractory NHL; yttrium-90 linked to ibritumomab tiuxetan (Zevalin) was approved in 2002. Tositumomab, like ibritumomab, is a monoclonal antibody of mouse origin that binds to the CD20 antigen present on the surface of >90%...

Tadalafil (Cialis - Lilly Icos) is the third oral drug to be approved by the FDA for treatment of erectile dysfunction. It has a longer duration of action than sildenafil (Viagra) or vardenafil (Levitra - Medical Letter 2003; 45:77).

Daptomycin (Cubicin - Cubist), a cyclic lipopeptide (a new class of antibiotics), has been approved by the FDA for intravenous (IV) treatment of complicated skin and skin structure infections. It is being promoted as a once-daily bactericidal alternative to vancomycin (Vancocin, and others) for methicillin-resistant Staphylococcus aureusinfections.

Epinastine HCl, an H₁-receptor antagonist and mast cell stabilizer, has been approved by the FDA for use in a 0.05% ophthalmic solution (Elestat - Allergan/Inspire) for prevention of itching associated with allergic conjunctivitis. The drug is available orally in Europe and Asia.

The FDA has determined that 3 generic formulations of levothyroxine are therapeutically equivalent to brand-name formulations. Some brand-name manufacturers have objected, and endocrine organizations have expressed their concern.
See levothyroxine addendum

The FDA has approved pegaptanib sodium (Macugen - Pfizer/Eyetech) as an intravitreous injection for treatment of all subtypes of neovascular (wet) age-related macular degeneration (AMD). The only other approved treatment for this condition is photodynamic therapy with intravenous verteporfin (Visudyne), which is recommended only for patients with one subtype (predominantly classic) of neovascular AMD.

A live attenuated varicella-zoster vaccine (Zostavax - Merck) has been approved by the FDA for prevention of herpes zoster (HZ; zoster; shingles) in persons ≥60 years old. Each dose of Zostavax contains about 14 times as much varicella-zoster virus (VZV) as Varivax, which has been used in the US since 1995 to vaccinate against varicella (chicken pox).

Some patients with primary immune deficiency are injected with intravenous immune globulin (IVIG) every 3-4 weeks. Now a subcutaneous immune globulin (SCIG) has also been approved in the US for this indication (Vivaglobin - CSL Behring). SCIG has been used in Europe for about 10 years.