Vedolizumab Dose Escalation: In for a Penny,in for a Pound?

Digestive Diseases and Sciences -     

What is a rheumatologist for?

Ask any individual rheumatologist, and I suspect that the answerwill be clear. Collectively, however, our specialty includesthe management of a diverse range of conditions ranging fromlife-threatening vasculitis, inflammatory arthritis and osteoporosisto soft tissue pain and chronic pain. In the UK, current dogmafrom the health commissioners dictates that much of this activitymight be taken away from the specialty and given to other clinicianssuch as primary care doctors and nurse or physiotherapy practitionerson the grounds of cost saving. This change in emphasis is potentiallya major threat to rheumatology as a specialty and the rheumatologistas an individual. This reflects     

Life-prolonging measures for a dead theory?

In a recent review article, Selman and colleagues (Trends Ecol Evol 27:570–577, 2012) discuss the status quo of the oxidative stress theory of aging (OSTA) and how it links to life history evolution. They suggest that the OSTA should be tested in wild populations which might show effects masked in laboratory settings. We disagree with their propositions for several reasons. We argue that there is increasing evidence that reactive oxygen species (ROS) are not causally linked with aging and that ROS do not play a straightforward role in shaping life history evolution. We propose that laboratory animals and semi-wild populations rather than wild animals are suited best to test any hypothesized effect of reactive oxygen species. This is because data from controlled manipulative experiments rather than observational correlations are preferred to solve this issue. In addition, nonconventional model organisms will be useful in answering the question how relevant the OSTA could be for life history evolution.     

Self-testing for HIV: a new option for HIV prevention?

Self-testing has the potential to be an innovative component to community-wide HIV-prevention strategies. This testing method could serve populations who do not have access to standard voluntary counselling and testing services or because of privacy concerns, stigma, transport costs, or other barriers do not use facility-based, standard HIV testing. This paper reviews recent research on the acceptability, feasibility, and cost of rapid testing and home-specimen collection for HIV, and suggests that self-testing may be another important strategy for diagnosing HIV infection. Several research questions are posed that should be answered before self-testing is realised.