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Previous studies of doxycycline have measured AAA with ultrasound instead of CT scan. Also, ultrasound measurements do not assure ascertainment of the maximal aortic diameter and make taking aortic tortuosity into account difficult. We agree with the interpretation of PHAST that 100 mg of doxycycline per day does not lead to favorable ultrasound-measured AP diameter effects in doxycycline-treated patients. Still, the lower dose of doxycycline used in PHAST could be appropriate for prevention of aneurysm rupture. In PHAST, the count of deaths and ruptures favored doxycycline over placebo, although not more than one could expect by chance. A randomized trial with the power to show a difference in clinical event endpoints would be necessary to know whether or not there is a clinical event benefit to be obtained from doxycycline at either the PHAST dose (100 mg daily) or our dose (200 mg daily). We look forward to concluding N-TA 3 CT recruitment and follow-up, obtaining new information important for patient care and future research. If doxycycline reduces aneurysm growth by 40% or more, changes in medical practice might save a portion of AAA patients from invasive treatments that carry inescapable if infrequent adverse outcomes. Finally, we believe that the information obtained from this trial will result in new understanding of the biology of human AAA. Coffey, Vikram Kashyap, Joao Lima, Jeremy Walston Footnotes Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. References 1.
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here across the way on her side of the valley was a little house and its windows glistened golden. s the sun shone on her little home. She realised that she had been living in her golden house and all the love and care she found there was what made her home the 'golden house'. Everything she dreamed was right there in front of her nose. The crossing of the Nefud desert is considered impossible, even by the local Arabs, but Lawrence persuades them that, in this way, they can take the Turkish port at Aqaba from the rear. Having carried out the superhuman feat of traversing this furnace, it is discovered that one of the Arabs, Gasim, has fallen off his camel and is no doubt dying somewhere back in the desert. This sense of anti-determinism and this belief that anything is possible has stayed with me always and continues to inspire me in small ways and large. There is a Chinese story of an old farmer who had an old horse for tilling his fields. One day the horse escaped into the hills and, when all the farmer's neighbours sympathised with the old man over his bad luck, the farmer replied, 'Bad luck. A week later the horse returned with a herd of wild horses from the hills and this time the neighbours congratulated the farmer on his good luck. Then, when the farmer's son was attempted to tame one of the wild horses, he fell off its back and broke his leg.
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