Research has generally confirmed that standard treatment approach

Research has generally confirmed that standard treatment approaches with proven efficacy in younger populations are likely to be successful when extended to the elderly, and that old age in itself should not be considered a contraindication to

their use. However, even though safe and effective treatments are available, nihilistic attitudes on the part of professionals and negative attitudes of the elderly themselves about psychiatric treatment remain barriers to treatment. Coexisting factors that frequently accompany advanced Inhibitors,research,lifescience,medical age – for example, comorbid medical and neurological illness, substance abuse, dementia, and cognitive impairment – are probably greater influences than age itself on the effectiveness of antidepressant treatments in elderly patients. Such comorbidities may interfere with the modes of action of specific treatments. Conversely,

effective treatment can improve outcomes of medical treatments and rehabilitation Inhibitors,research,lifescience,medical efforts for physical illness in the elderly, and influence survival (ie, depression Inhibitors,research,lifescience,medical is a risk factor for mortality). Finally, depression is a risk factor for medical illness, and can complicate its treatment. Thus, there may be serious risks of not treating depression in physically ill elders (Reynolds, this issue, pp 95-99). Much of the treatment of depression in the elderly occurs within the primary medical health care context, if it occurs at all. Moreover, family members, typically spouses or daughters, provide the

bulk of care for older patients with mental disorders, often experiencing considerable stress in the process. A high proportion of patients experiencing Inhibitors,research,lifescience,medical an episode of major depression in late life will have had at least one previous episode, or will have a subsequent recurrence. The literature pertaining to the long-term prevention of a recurrence of depression is discussed elsewhere in this volume (Reynolds, this issue, pp 95-99). These studies indicate that the longterm Inhibitors,research,lifescience,medical prevention of new episodes of disorder in elderly patients can be best achieved by maintaining patients on the same dosage of antidepressant medication that was used to Phosphatidylinositol diacylglycerol-lyase treat the acute episode, and by maintaining psychotherapy. Current recommendations are for treatment to be continued for at least 6 months after remission1 (Agency for Health Care Docetaxel purchase Policy and Research [AHCPR], 1993). Newer information, however, suggests a longer treatment period may be necessary (Reynolds, this issue, pp 95 -97). Pharmacotherapy Over the years, the amount of data from randomized clinical trials or controlled clinical observation of antidepressant agents in elderly patients has been rather limited, although in recent years there has been a significant increase. Trials in mixed-age adults include very few patients over 60 years of age.

Their response was published in the Bulletin of the Association o

Their response was published in the Bulletin of the Association of Swiss Physicians (FMH), and was subsequently distributed by CFV to physicians. Available on the Internet, it informs the public on the non-objectivity of the brochure

as it relates to vaccination questions. Indeed, a group of experts made up of members of the CFV has provided Ku-0059436 order responses to questions raised by the brochure in a document titled Guide sur les vaccinations: évidences et croyances [3] (a guide for vaccinations: evidence and beliefs). Preparation of meetings, including setting agendas and proposing areas of work, is shared between the committee and the Secretariat under the auspices of FOPH, within the Federal Department of Home Affairs. FOPH and external bodies can make suggestions but cannot impose them; theoretically, proposals can come from different political or medical groups, such as medical societies concerned with occupational health. At each meeting, the CFV identifies issues for future discussion. These issues may be identified

during the commission’s work meetings, or be requested by other commissions, specialist groups, physicians or other involved parties. All topical requests that fall under the competencies of the CFV, in particular those concerning vaccines, prevention Libraries strategies and applications, p53 inhibitor can be brought to the CFV’s attention through the Secretariat. Vaccination recommendations must be based on scientific evidence, integrating whenever possible a hierarchical classification system for study validity. This analytical framework is used as a foundation for discussions within the CFV, as well as for approaching the federal commission concerning the benefits of compulsory health insurance. The potential benefits of each vaccine for individual and public health are identified by the CFV, in collaboration with the FOPH, after a rigorous assessment of numerous parameters

in response to a series until of analytical questions. The working group for new vaccines has decided to develop an analytical framework allowing for a systematic and exhaustive assessment of all factors pertinent to the decision-making process and ultimately for the recommendation of a vaccine. A similar process was already established in Quebec and was made available to the commission. Quebec’s process was adapted to Swiss needs and is comprised of a series of essential questions as well as a list of elements requiring analysis. The questions are as follows [4]: • Do the properties of the vaccine allow for the establishment of an efficacious and safe recommendation? Using answers to these questions as a basis, the CFV has established four categories of vaccines for recommended use: 1. Basic vaccines – they are essential to individual and public health, and offer a level of protection that is indispensable to people’s well-being (e.g., diphtheria, tetanus, pertussis, polio, MMR, HBV, HPV).

ValleniBasile et al68 surveyed a community

sample of 3283

ValleniBasile et al68 surveyed a community

sample of 3283 adolescents in the southeastern USA and found a 3% prevalence of OCD. They also identified a group of adolescents who had symptoms of OCD, but were not considered impaired. The prevalence of subclinical OCD, by this definition, was 19%. In a separate study, Valleni-Basile et al68 found that the 1-year incidence rate of OCD in this population was 0.7%. Interestingly, an initial S3I-201 manufacturer diagnosis of subclinical OCD was not significantly predictive of a diagnosis of OCD at 1-year follow-up. The authors concluded that an initial diagnosis of subclinical Inhibitors,research,lifescience,medical OCD was not a precursor to the development of clinical OCD with impairment of functioning. In the ECA study, prevalence rates of OCD were higher among women than men. However, when gender comparisons were controlled for marital status, employment status, job status, ethnicity, and age, there were no remaining differences in prevalence rates for women and men. In the Cross-national Collaborative Study, rates were generally Inhibitors,research,lifescience,medical higher in women, except in Munich, where the rates were higher among men. At least one prospective epidemiological study has suggested Inhibitors,research,lifescience,medical candidate risk factors for OCD. Crum and Anthony used data from the ECA study to estimate the degree to which the risk of OCD might be elevated among

adults actively using cocaine.69 Using 1-year prospective follow-up data, they identified 105 incident cases of OCD among 13 306 at-risk study participants. Subjects actively using cocaine were at substantially increased risk for OCD. In the Cross-national Collaborative Inhibitors,research,lifescience,medical Study, persons with OCD were found to have a substantially greater risk of having comorbid major depression or another anxiety disorder compared with persons Inhibitors,research,lifescience,medical without OCD across all sites, even though the comorbidity rates and the magnitude of the risk varied by site. The proportion of persons with OCD and any anxiety disorder was higher than the proportion with major depression

at all sites.70 Posttraumatic stress disorder Diagnosis PTSD is defined in DSM-III as a constellation of symptoms in response to a stressor, including reexperiencing a traumatic event, a numbing of responsiveness, and symptoms of an increased level of arousal.71,72 Thymidine kinase In DSM-III-R, the symptoms are required to persist for at least 1 month and the criteria are broadened by adding intense psychological distress in response to events that symbolize or resemble an aspect of the trauma and avoidance of stimuli associated with the event.73 In DSM-IV, the requirement for functional impairment or clinically significant distress is added.74 Symptoms (acute 2-4 weeks; chronic >4 weeks) Reexperiencing a traumatic event in recollections, dreams, flashbacks. Avoidance of stimuli associated with the event. Sleep disturbances, hypervigilance. Prevalence Until recently, accurate information on the prevalence of PTSD was not available.

There was also a significant decrease (P < 0 05) in mitochondrial

There was also a significant decrease (P < 0.05) in mitochondrial swelling with the CsA-treated hypoxic group, as shown by 14.83% decrease in absorbance. When a comparison was made, FK-506 decreased mitochondrial swelling more efficiently than CsA (Fig. 2). Figure 2 Calcium uptake in spinal cord mitochondria. Mitochondria (25 mg/reaction) were deenergized via incubation

in isotonic buffer at room selleck inhibitor temperature for 3 min. After incubation, calcium (100 μM) was added to the reaction mixture and absorbance was … Tissue LPO level As a result of spinal hypoxia/reperfusion, a significant increase (P < 0.001) in LPO level was observed in the hypoxic group as compared with sham values. Drug treatment with either FK-506 or CsA resulted in a significant Inhibitors,research,lifescience,medical (P < 0.01–0.001) decrease in the level of LPO in the FK-506 + Hypoxia and CsA + Hypoxia groups when

compared to hypoxic group (Fig. 3). No significant difference was observed between both the drug-treated groups. Figure 3 Rate of lipid Inhibitors,research,lifescience,medical peroxidation (LPO) in different groups. Values are expressed as mean ± SE (n = 6). Significant difference §P < 0.001 when compared with sham; *P < 0.01, **P < 0.001 when compared with hypoxic group. ... Tissue GSH content Spinal hypoxic damage significantly (P < 0.001) depleted the GSH content in mitochondria in the hypoxic group over sham values (Fig. 4). As a result of FK-506 and CsA treatment, a significant (P < 0.01) restoration in mitochondrial GSH content Inhibitors,research,lifescience,medical was seen in the FK-506 + Hypoxia and

CsA + Hypoxia groups when compared with the hypoxic group. No significant difference was observed between both the drug-treated groups. Figure 4 Reduced glutathione (GSH) Inhibitors,research,lifescience,medical content in various groups. Values are expressed as mean ± SE (n = 6). Significant difference §P < 0.001 when compared with sham; *P < 0.01 when compared with hypoxic group. Hypoxia resulted in Inhibitors,research,lifescience,medical ... Tissue MPO activity A significant (P < 0.001) increase in MPO activity was seen in the hypoxic group compared to sham values. It was observed that treatment with either FK-506 (P < 0.001) or CsA (P < 0.01) caused a significant decrease in MPO activity in the FK-506 + Hypoxia and CsA + Hypoxia groups as compared to the hypoxic group (Fig. 5). It was observed that FK-506 significantly (P < 0.01) decreased MPO activity (42.86%) than CsA (18.66%). Figure 5 not Myeloperoxidase (MPO) activity in various groups. Values are expressed as mean ± SE (n = 6). Significant difference §P < 0.001 when compared with sham; *P < 0.01, **P < 0.001 when compared with hypoxic group and … Tissue viability TTC staining in sham did not show any detectable lesion (Fig. 6). On the contrary, sections obtained from hypoxic group showed detectable lesions as white patches. The lesions were present in both white and gray matter. It was observed that FK-506 and CsA treatment significantly decreased the lesions (P < 0.05) as compared to hypoxic group. Figure 6 Neuroprotective effect of FK-506 and CsA in spinal cord hypoxia.

Consequently, the individual’s sleep pattern becomes desynchroniz

Consequently, the individual’s sleep pattern becomes desynchronized from the circadian system

and, in the case of shift workers, daytime sleep duration is short, sleep efficiency is poor, and night-time waking alertness and performance are impaired,9 accounting for the high incidence of accidents and injuries experienced by nightshift workers.10 Other functions also become desynchronized Inhibitors,research,lifescience,medical under such conditions, for example, postprandial metabolism. When meals are taken during the biological night, they cannot be metabolized as efficiently as when eaten during the day, and Inhibitors,research,lifescience,medical consequently postprandial levels of glucose, Insulin, and fats are elevated.11-13 In the long term, the regular Impairment of metabolism Induced over years of shiftwork may lead to chronically elevated clrculating levels of Insulin and fat, and may increase the risk of developing Insulin resistance, diabetes, or cardiovascular disease.14 Gastrointestinal discomfort is also a common complaint In jet lag,15 most likely due to the temporal misalignment of circadian oscillators In peripheral tissues (eg, the liver, kidney, Inhibitors,research,lifescience,medical esophagus, and stomach) that have recently been Identified (for review

see ref 16). The potential Inhibitors,research,lifescience,medical GSK126 in vitro Importance of light In human circadian entrainment was first explored in cave experiments, where investigators measured rhythms In physiology and behavior when shielded from the solar day (although dim artificial light was generally available).17,18 These studies Indicated that the circadian Inhibitors,research,lifescience,medical pacemaker did not oscillate

exactly on a 24-hour day, but had a circadian period (x) that was on average slightly longer than 24 hours. Studies of subjects kept in temporal Isolation,19 In dim Hght-dark cycles,20,21 or on very long (eg, 28-h, 30-h, 42.85 h) or very short (eg, 11-h, much 20-h) day-lengths outside the range of entrainment of the biological clock have also shown that the period of the circadian clock Is not exactly 24 hours In humans (average -24.2 h)22,23 similarly to that In other mammals. Under such nonentrained conditions, the rhythms controlled by the circadian system ”free-run“ at the endogenous period of the biological clock. For example, If a person’s nonentrained period Is 24.5 h, the sleep-wake cycle and other rhythms will also cycle with a period of 24.5 h and the subject will therefore go to sleep 0.5 hours later each day, when measured using the 24hour clock (see below).

What is already known on this topic: The Berg Balance Scale score

What is already known on this topic: The Berg Balance Scale scores balance from 0 (very poor) to 56 (normal) and is widely used in many clinical populations. It has well-established, favourable clinimetric properties. What this study adds: Normative data from community-dwelling people aged around 70 years indicates a normal Berg Balance Scale score. With each subsequent year, however, mean scores decrease by about 0.7 points, and variability in the scores increases. Ethics: Not applicable. Competing interests: Nil. Support:

This research was conducted as part of a master’s degree by Stephen Downs with the University of Newcastle. The University provided academic supervision and use of the library, including electronically accessing papers and the use of ‘get-it’ to access papers not electronically available. Support has also been CHIR-99021 nmr provided to attend conferences to present PD0332991 mw research findings. No direct financial support has been provided. Acknowledgements: The authors acknowledge

Alastair Merrifield, who provided biostatistical advice while he was a trainee biostatistician with the NSW Centre for Epidemiology and Research. Correspondence: Stephen Downs, Transitional Aged Care Service, Bellingen Hospital, Bellingen 2454, Australia. Email: [email protected]
“Chronic low back pain is a very prevalent condition1 and it is associated with enormous health and socioeconomic costs.2 The prognosis of acute low back pain3 is initially favourable with reduction of pain and disability in the first six weeks. After this period, there is a slower improvement in symptoms for up to one year.3 Several treatments are available for people with chronic low back pain. These treatments include:

educational programs,4 medication,5, 6 and 7 electrophysical agents,8 manual therapy,9 exercises10 and others.11 Nevertheless, these treatments have, at best, a moderate effect, thus, more effective treatments are needed for low back pain.12 and 13 Kinesio Taping14 is a new method of treatment that is very popular in sports15 and it has also been proposed for people with low back pain.16 and 17 This technique makes use of elastic adhesive tape, which is applied to the patient’s skin under tension.14 The elastic tape that is used with only this technique can be extended up to 140% of its original length.14 The tape is thin and light, and made of 100% cotton fabric that is Modulators porous and does not restrict the range of motion. The tape is adhesive and activated by heat, does not contain latex, and is reported to have similar elasticity to the skin.14 The tape can last for a period of three to five days and can be used in water. The expansion of the Kinesio® Tex Tape is only in the longitudinal direction.14 During patient assessment, the therapist decides what level of tension will be used.

Multiple stepwise regression analyses were performed to evaluate

Multiple stepwise regression analyses were performed to evaluate the influence of clinical factors on the differences in echocardiographic findings. A p-value of less than 0.05 was regarded as

having statistical significance. Results Study population Demographic and clinical characteristics of the study populations (metabolic and non-metabolic control groups) are summarized in Table 1. Age and gender distributions were similar in both groups. Although there was no significant difference in BMI, waist circumference was significantly larger in the MS than in the control group. Another remarkable Inhibitors,research,lifescience,medical GDC-0973 mouse variation was demonstrated in terms of BP and TG levels between the two groups. The FSG and HDL levels were not significantly different between the two groups. Thus, MS patients included in the present study had minimal risk factors for MS. Table 1 Demographic and clinical characteristics M-mode, two-dimensional, and conventional doppler echocardiography M-mode, 2D, and conventional Doppler echocardiographic measurements are shown in Table 2. LV size, Inhibitors,research,lifescience,medical LV mass, LA size, and LVEF were not significantly different between the two groups. LV diastolic function estimated by conventional Doppler criteria was similar in both groups. Thus, there were no significant differences Inhibitors,research,lifescience,medical in the prevalence of systolic

and diastolic dysfunction when assessed by 2D and conventional Doppler echocardiography. Inhibitors,research,lifescience,medical Table 2 Two-dimensional and pulsed wave Doppler echocardiography Tissue doppler imaging Echocardiographic measurements

by TDI are summarized in Table 3 and Fig. 1. Tissue Doppler velocities of the lateral annulus were 8.8 ± 2.4 and 11.8 ± 1.9 cm/s (p < 0.001) in the MS and control groups, respectively. Average values of Sm and Em measured at 8 myocardial segments were significantly lower in the MS group than in the control group (2.7 Inhibitors,research,lifescience,medical ± 0.4 vs. 4.0 ± 1.0 cm/s, p < 0.001; 4.0 ± 1.3 vs. 5.5 ± 1.4 cm/s, p = 0.008, respectively). In addition, average values of Ssr, Esr, and PSS were also significantly lower Terminal deoxynucleotidyl transferase in the MS group than in the control group (1.1 ± 0.3 vs. 1.4 ± 0.3 s-1, p = 0.001; 1.2 ± 0.3 vs. 1.5 ± 0.3 s-1, p = 0.013; and 16.9 ± 3.7 vs. 20.5 ± 3.2%, p = 0.001, respectively). Fig. 1 Mean values of myocardial velocities and strain rate by tissue Doppler imaging in control and MS group. MS: metabolic syndrome, Sm: peak systolic, Em: early diastolic, Ssr: peak systolic, Esr: early diastolic. Table 3 Myocardial velocities, strain rates, and peak systolic strain Relationship of clinical and echocardiographic parameters Linear regression analysis was performed to examine the relationship of echocardiographic measurements to clinical parameters in patients with MS and non-MS (Table 4). Age significantly correlated with all echocardiographic parameters representing myocardial function.

Anuradha Reddy for their

Anuradha Reddy for their SNS-032 concentration constant encouragement. “
“Liver is one of the largest organ play vital roles in human body and liver diseases are some of the fatal disease in the world today. A healthy liver is a crucial factor for overall

health and well-being because liver involves in metabolism, secretion, storage and excretion. Any injury to liver can result in many disorders ranging from transient elevation in liver enzyme to life threatening liver cirrhosis and hepatic failure. The common causative agents of liver injuries are alcohol, poor drug habits, over-the-counter drugs, toxic chemicals (e.g. CCl4, aflatoxin etc.), therapeutic drugs (e.g. Antibiotics, anti-tubercular drugs etc.) and microbial agents (e.g. hepatic virus, leptospira, malarial parasites) which can eventually lead to various liver ailments like hepatitis, cirrhosis and alcoholic liver disease. So liver has a surprising role to play in the maintenance, performance and regulating homeostasis of the body. It is involved with almost all the biochemical pathways to growth, fight against disease, nutrient supply, energy provision and reproduction.

The modern medicines have little to offer Selleckchem Compound Library for alleviation of hepatic diseases but there is not much drug available for the treatment of liver disorders.1 The plant Swertia chirayita Buch-Ham (Gentianaceae) is one of the oldest herbal medicines used against bronchial asthma and liver disorders from ancient time in western India. It has been widely used in Ayurvedic and Unani medicine system as an anthelmintic, febrifuge and stomach and protective liver tonic. 2 and 3 The herb containing amarogentin (most

bitter compound isolated till date) as main chemical constituent attributed anthelmintic, hypoglycemic and antipyretic properties. Swerchirin a compound with xanthone structure has hypoglycaemic, hepatoprotective activity 4 and 5 and the xanthone content of Swertia is mostly responsible oxyclozanide for its hepatoprotective activity. 6 Andrographis paniculata (Burm. f.) Nees, (family: Acanthaceae) commonly and locally known as “Kalmegh” is an important traditional medicinal plant, occurring wild in different region of India, and is used both in Ayurveda and Unani system of medicine. 7 It is also known as “King of Bitters”, and is a member of ancient medicinal herb with an Modulators extensive ethnobotanical history in Asia. Modern pharmacological studies indicate that active compound andrographolide are very bitter diterpene lactones protects the liver and gallbladder, and has been found to be slightly more active than Silymarin, a known hepatoprotective drug 8 Neo-andrographolide shows greater activity against malaria 9 while 14-deoxy andrographolide produced a more potent hypotensive effect in anaesthetized rats.

Either telescoping the rim strip with flap or excising a small po

Either telescoping the rim strip with flap or excising a small portion of the flap to create a void into which the LLC would telescope can affect retrodisplacement. Kridel and Konior,13 later introduced a lateral crural overlay technique. In

this technique the lateral crus was cut vertically at its middle portion. Then the cut ends were overlapped and sutured to shorten the total length of the lateral crus.11 Other procedures such as medial crura shortening SB203580 molecular weight techniques have also been employed for deprojection. Lipsett,10 advocated splitting the LLC medial to the dome, resecting a length of the cartilage Inhibitors,research,lifescience,medical just lateral to the incision, and reshaping the lateral crus remnant, using multiple scoring incisions on the cartilage to recreate a new dome. This was performed using a rim incision and a cartilage delivery technique. Other experts have made some modifications in the Lipsett’s Inhibitors,research,lifescience,medical technique. For example, they preserved the underlying vestibular skin, delivered the cartilage with a marginal incision and morselized the cartilage. The excision of medial crura foot pods to deproject the nasal

tip was also suggested by Guyuron and colleagues.6 The lateral and medial crura need to be equally shortened in order to deproject the nasal tip without Inhibitors,research,lifescience,medical altering tip rotation. Joseph and Safian,15 favored excising the lateral and medial crura elements to achieve deprojection. Close, et al,16 removed a calculated length of the medial and lateral crura. The remnants would be sutured together end to end. Later, medial and lateral crura overlay and suturing techniques were combined by Foda et al,17 for deprojection. Vertical Dome Division is a versatile mean of nasal tip alteration. The hockey-stick,11 approach is a technique among the vertical division Inhibitors,research,lifescience,medical techniques, which includes the Goldman procedure and the Simon’s modification. We believe our technique is suitable for three main objectives: (1) nasal tip deprojection, (2) increasing tip rotation, and (3) decreasing tip rotation especially in revision cases with over-rotated tips. In fact, Inhibitors,research,lifescience,medical by changing

the site of cartilage removal, we can achieve different from goals depending on the deformity. The most frequent complication of our technique is widening of the tip since the dome area is the narrowest part of the lower lateral cartilage removed in this technique. This area, in fact, is replaced by a much wider part of LLC. Reasonably, this causes widening of tip area. To avoid this, we did narrow the new tip area as much as possible by removing cartilage from the cephalic part of LLC and inserted a tip graft in most patients. Using the tip graft helps to minimize this complication, define the tip area, and camouflage suture knots and visible cartilage cut ends, which are the second most common complications of this technique especially in thin-skinned patients. No other major complications were observed in our patients.

It subsequently shrank back to smaller and steady numbers based o

It subsequently shrank back to smaller and steady numbers based on the cumulative this website evidence generated in major studies. Bypass surgery became the standard of care for multi-vessel and left main revascularization procedures and remains valid to this day. A CLINICALLY DRIVEN PASSIONATE INNOVATOR—THE BIRTH OF INTERVENTIONAL CARDIOLOGY Percutaneous transluminal coronary angioplasty (PTCA) was the Inhibitors,research,lifescience,medical next frontier challenging the surgical methods for coronary revascularization. The concept

of transluminal angioplasty was suggested by Charles Dotter as early as 1964.6 Dotter pioneered modern medicine with the invention of angioplasty, which was first used to treat peripheral arterial Inhibitors,research,lifescience,medical disease. Dotter is commonly known as the “Father of Interventional Radiology” and was nominated for the Nobel Prize in Medicine in 1978. Dr Andreas Grüntzig followed Dotter’s concept in 1974 and performed the first peripheral human balloon angioplasty.7 However, he did not stop there. Grüntzig hypothesized that coronary blockages can be Inhibitors,research,lifescience,medical dilated by a balloon in an alert patient and that the artery will remain open after that. He achieved his goal by building some experimental balloons on long catheters from plastic materials available at that time. In 1977

he treated the first patient with this technique and dilated a proximal lesion at the left anterior descending artery.8 The patient recovered and that artery Inhibitors,research,lifescience,medical remained open for many years. The balloon that Grüntzig developed looks exactly like the balloons used today. The field of interventional cardiology was born by the passion of a physician who carried his idea to the patient’s bedside. That technology, broadly known today as percutaneous coronary

intervention (PCI), sparked a lot of criticism. In the early days of angioplasty, the dilated artery would close abruptly in up to 10% of patients, leading to mortality in over 30% of those Inhibitors,research,lifescience,medical patients. In addition, restenosis occurred within 3 months in over 30% of the patients due to a combination of vessel recoil and intimal proliferation, in response to the injury caused by balloon dilatation. Over the years, materials have improved and the thinner profile of newer catheters allowed less traumatic interventions. Nevertheless, balloon dilatation continued to be limited by acute occlusion and restenosis, Ergoloid necessitating the search for appropriate solutions. In summary, Andreas Grüntzig, an enthusiastic, passionate, and talented physician who was inspired by earlier pioneers, was able to solve technological and conceptual barriers and apply his solution to patients bravely, in the face of much criticism. His work gave birth to a fascinating new world and opened the door for the influx of new technologies for years to come. He died in 1985 in a plane accident, but the field that he inspired has grown beyond his expressed dreams.