The recent attack in the Tokyo subway has led to many questions about the clinical effects, treatment and prevention of nerve gas poisoning.

All refractive corneal surgery reshapes the cornea to redirect light rays so that they focus on the retine....

Bivalirudin is being promoted as an intravenous (IV) anticoagulant that can be used instead of heparin in patients with unstable angina undergoing coronary angioplasty.

Alefacept (a le' fa sept; Amevive - Biogen) has been approved by the FDA for parenteral treatment of adults with moderate to severe chronic plaque psoriasis.

Laparoscopic surgery has become increasingly popular for the treatment of gastroesophageal reflux disease (GERD). The usual surgical procedure, a Nissen fundoplication, prevents reflux into the esophagus. The review compares medical treatment with a proton pump inhibitor vs. surgical therapy as well as open vs. the new laparoscopic technique. Morbidity and mortality with the procedures are discussed.

While more people than ever are getting tattoos, many come to regret their decision and would like to have them removed. The technology of removing tattoos is much better than it used to be, but still far from perfect. Complete removal of all pigments with restoration of normal skin color and texture is not always possible (M Kuperman-Beade et al, Am J Clin Dermatol 2001; 2:21; GM Lipper and RR Anderson in IM Freedberg et al, eds, Fitzpatrick's Dermatology in General Medicine 6th ed, New York:McGraw-Hill 2003, page 2508).

Low-dose aspirin is widely used as an antiplatelet drug to reduce the risk of cardiovascular disease (Medical Letter 2000; 42:18). Recent reports suggest that the nonsteroidal anti-inflammatory drug (NSAID) ibuprofen (Motrin, and others) may decrease the efficacy of aspirin for this indication. The manufacturer of Tylenol is capitalizing on these reports by advertising that aspirin-taking patients who need pain relief should use acetaminophen instead of ibuprofen.

A device that stimulates the vagus nerve was approved by the FDA in July 1997 for treatment of refractory epilepsy and is now considered "approvable" for treatment-resistant depression.

Deferasirox (Exjade - Novartis), an oral chelating agent, recently received accelerated approval from the FDA as an orphan drug for oral treatment of chronic iron overload due to blood transfusions (transfusional hemosiderosis) in patients >2 years old. Deferasirox is a tridentate (2 molecules of deferasirox bind to one atom of iron) chelating agent with high affinity for iron. It has much lower affinity for zinc and copper.

The 2006 Medical Letter article on the then-new varicella-zoster vaccine concluded that Zostavax appears to be safe and effective in protecting patients ≥60 years old against herpes zoster and postherpetic neuralgia, especially in reducing the severity and duration of the disease.1 Some new information has recently become available.CLINICAL STUDIES — A Veterans Administration randomized, double-blind trial enrolled more than 38,000 patients ≥60 years old and followed them for a mean of 3.4 years after administration of Zostavax or placebo. Since the efficacy of the vaccine had been...