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Books > Medicine > Clinical & internal medicine > Diseases & disorders > Oncology

Antimicrobial Peptides - Basics for Clinical Application (Hardcover, 1st ed. 2019): Katsumi Matsuzaki Antimicrobial Peptides - Basics for Clinical Application (Hardcover, 1st ed. 2019)
Katsumi Matsuzaki
R4,665 Discovery Miles 46 650 Ships in 10 - 15 working days

This book presents an overview of antimicrobial peptides (AMPs), their mechanisms of antimicrobial action, other activities, and various problems that must still be overcome regarding their clinical application. Divided into four major parts, the book begins with a general overview of AMPs (Part I), and subsequently discusses the various mechanisms of antimicrobial action and methods for researching them (Part 2). It then addresses a range of activities other than antimicrobial action, such as cell penetration, antisepsis, anticancer, and immunomodulatory activities (Part 3), and explores the prospects of clinical application from various standpoints such as the selective toxicity, design, and discovery of AMPs (Part 4). A huge number of AMPs have been discovered in plants, insects, and vertebrates including humans, and constitute host defense systems against invading pathogenic microorganisms. Consequently, many attempts have been made to utilize AMPs as antibiotics. AMPs could help to solve the urgent problem of drug-resistant bacteria, and are also promising with regard to sepsis and cancer therapy. Gathering a wealth of information, this book will be a bible for all those seeking to develop antibiotics, anti-sepsis, or anticancer agents based on AMPs.

Novel therapeutic approaches for gastrointestinal malignancies (Hardcover, 1st ed. 2020): Ganji Purnachandra Nagaraju, Sujatha... Novel therapeutic approaches for gastrointestinal malignancies (Hardcover, 1st ed. 2020)
Ganji Purnachandra Nagaraju, Sujatha Peela
R2,897 Discovery Miles 28 970 Ships in 10 - 15 working days

This book provides an up-to-date overview of gastrointestinal malignancies, including prevention, early detection, intervention, and life-extending therapeutics. It also assesses various biomarkers used for diagnostics, prognostics and prediction of response to chemoresistance. Further, it discusses the latest trends in the use of small-molecule targeted therapies and immunotherapies as single agents or combination with other treatments. Since resistance to radiation and chemotherapy contribute to the high recurrence and poor survival rates, improving the outcome for GI malignancies is dependent on the introduction of new biomarkers and therapeutic agents. Lastly, the book systematically investigates novel theranostics approaches using nanotechnology for the detection, diagnosis, and personalized treatment of GI malignancies.

Biomechanics in Oncology (Hardcover, 1st ed. 2018): Cheng Dong, Nastaran Zahir, Konstantinos Konstantopoulos Biomechanics in Oncology (Hardcover, 1st ed. 2018)
Cheng Dong, Nastaran Zahir, Konstantinos Konstantopoulos
R4,692 Discovery Miles 46 920 Ships in 10 - 15 working days

This book covers multi-scale biomechanics for oncology, ranging from cells and tissues to whole organ. Topics covered include, but not limited to, biomaterials in mechano-oncology, non-invasive imaging techniques, mechanical models of cell migration, cancer cell mechanics, and platelet-based drug delivery for cancer applications. This is an ideal book for graduate students, biomedical engineers, and researchers in the field of mechanobiology and oncology. This book also: Describes how mechanical properties of cancer cells, the extracellular matrix, tumor microenvironment and immuno-editing, and fluid flow dynamics contribute to tumor progression and the metastatic process Provides the latest research on non-invasive imaging, including traction force microscopy and brillouin confocal microscopy Includes insight into NCIs' role in supporting biomechanics in oncology research Details how biomaterials in mechano-oncology can be used as a means to tune materials to study cancer

Advances in Cancer Research, Volume 88 (Hardcover): George F. Vande Woude Advances in Cancer Research, Volume 88 (Hardcover)
George F. Vande Woude
R3,815 Discovery Miles 38 150 Ships in 12 - 19 working days

The Advances in Cancer Research series provides invaluable information on the exciting and fast-moving field of cancer research. This volume presents outstanding and original reviews on a variety of topics, including HAMLET and tumor cells; survivin and apoptosis control; retroviral insertional mutagenesis; aberrant ubiquitin-mediated proteolysis of cell cycle regulatory proteins and oncogenesis; and epigenetic variability and the evolution of human cancer.
The Advances in Cancer Research series provides invaluable information on the exciting and fast-moving field of cancer research. This volume presents outstanding and original reviews on a variety of topics, including HAMLET and tumor cells; survivin and apoptosis control; retroviral insertional mutagenesis; aberrant ubiquitin-mediated proteolysis of cell cycle regulatory proteins and oncogenesis; and epigenetic variability and the evolution of human cancer.

Advances in Cancer Research, Volume 87 (Hardcover): George F. Vande Woude, George Klein Advances in Cancer Research, Volume 87 (Hardcover)
George F. Vande Woude, George Klein
R3,819 Discovery Miles 38 190 Ships in 12 - 19 working days

The Advances in Cancer Research series provides invaluable information on the exciting and fast-moving field of cancer research. This volume presents outstanding and original reviews on a variety of topics, including chromosome instability in cancer; telomerase inhibitors as an option for chemotherapy; avian retrovirus pathogenicity; Epstein-Barr virus and undifferentiated nasopharyngeal carcinoma; immunotherapy for prostate cancer; and the role of lymphocytes in anti-tumor immunity.
The Advances in Cancer Research series provides invaluable information on the exciting and fast-moving field of cancer research. This volume presents outstanding and original reviews on a variety of topics, including chromosome instability in cancer; telomerase inhibitors as an option for chemotherapy; avian retrovirus pathogenicity; Epstein-Barr virus and undifferentiated nasopharyngeal carcinoma; immunotherapy for prostate cancer; and the role of lymphocytes in anti-tumor immunity.

Androgen Action in Prostate Cancer (Hardcover, 2009 ed.): Donald Tindall, James Mohler Androgen Action in Prostate Cancer (Hardcover, 2009 ed.)
Donald Tindall, James Mohler
R4,535 Discovery Miles 45 350 Ships in 10 - 15 working days

Androgens are critical regulators of prostate differentiation and function, as well as prostate cancer growth and survival. Therefore, androgen ablation is the preferred systemic treatment for disseminated prostate cancer. Androgen action is exerted in target tissues via binding the androgen receptor (AR), a nuclear receptor transcription factor.

Historically, the gene expression program mediated by the AR has been poorly understood. However, recent gene expression profiling and more traditional single-gene characterization studies have revealed many androgen-regulated genes that are important mediators of androgen action in both normal and malignant prostate tissue. This book will focus on the androgen-regulated gene expression program, and examine how recently identified androgen-regulated genes are likely to contribute to the development and progression of prostate cancer. Recent studies that have attempted to unravel how these genes are deregulated in androgen depletion independent prostate cancer will be included

Ovarian Cancer, An Issue of Hematology/Oncology Clinics of North America, Volume 32-6 (Hardcover): Ursula A. Matulonis Ovarian Cancer, An Issue of Hematology/Oncology Clinics of North America, Volume 32-6 (Hardcover)
Ursula A. Matulonis
R2,264 Discovery Miles 22 640 Ships in 12 - 19 working days

This issue of Hematology/Oncology Clinics, edited by Dr. Ursula Matulonis, will focus on Ovarian Cancer. Topics include, but are not limited to, Risk factors for ovarian carcinoma; Ovarian cancer pathology; Early detection and prevention strategies for ovarian cancer; Pathogenesis, genetics and genomics of high grade serous cancer; Pathogenesis, genetics and genomics of non-high grade serous cancers; Management and Treatment of newly diagnosed ovarian cancer; Management and Treatment of recurrent ovarian cancer; Treatment of rare epithelial ovarian tumors; Targeting DNA damage response and repair as a therapeutic strategy for ovarian cancer; Mechanisms of drug resistance in ovarian cancer; The status of and targeting the immune system in ovarian cancer: current and future approaches; Antibody drug conjugates; The role of angiogenesis in ovarian cancer pathogenesis and treatment; Management and understanding of acute and long term toxicities of patients with ovarian cancer; and Palliative Care of the advanced ovarian cancer patient.

Anoikis - How the Extracellular Matrix Regulates Life-or-Death Decisions (Hardcover, 1st ed. 2021): Steven M. Frisch Anoikis - How the Extracellular Matrix Regulates Life-or-Death Decisions (Hardcover, 1st ed. 2021)
Steven M. Frisch
R3,618 Discovery Miles 36 180 Ships in 10 - 15 working days

Anoikis is defined broadly as apoptosis that is inhibited by appropriate cell-matrix interactions. Normal and tumor cells vary widely in their sensitivity to anoikis, but, in general, metastatic tumor cells are inevitably anoikis-resistant. In particular, tumor cells that possess a cancer stem cell or mesenchymal phenotype, arising from the oncogenic Epithelial-Mesenchymal Transition (EMT), are transcriptionally re-programmed to resist anoikis. While the anoikis response occurs through the mitochondrial pathway typically found in other apoptotic responses (e.g., DNA damage, death receptors, oxidative stress), the regulation of anoikis by cell-matrix signalling is unique and only partially characterized. The uniqueness of anoikis is: a. regulation by integrins, non-integrin matrix receptors, and the signaling complexes associated with them; b. regulation by metabolic changes occurring in response to attachment/detachment; c. regulation by oncogenes and tumor suppressor genes d. regulation by tumor microenvironment; e. regulation by EMT.

Advances in Cancer Research, Volume 85 (Hardcover, 108 Ed): George F. Vande Woude, George Klein Advances in Cancer Research, Volume 85 (Hardcover, 108 Ed)
George F. Vande Woude, George Klein
R3,819 Discovery Miles 38 190 Ships in 12 - 19 working days

The Von Hippel-Lindau Tumor Suppressor Complex and Regulation of Hypoxia -Inducible Transcription. Retinoblastoma Tumor Suppressor and Genome Sta bility. The Abl Family Kinases: Mechanisms of Regulation an d Signaling. Cellular Immunity to the Her-2/neu Proto-oncog ene. A New Challenge for Successful Immunotherapy by Tumors That Are Resistant to Apoptosis: Two Complementary Signals to Overcome Cross-Resistance. Cell Volume and Ion Changes During Apopt otic Cell Death. Mitochondria and Apoptosis: New Therapeut ic Targets.

Advances in Cancer Research, Volume 86 (Hardcover, 108 Ed): George F. Vande Woude, George Klein Advances in Cancer Research, Volume 86 (Hardcover, 108 Ed)
George F. Vande Woude, George Klein
R3,815 Discovery Miles 38 150 Ships in 12 - 19 working days

Coordinate Regulation of Translation by the PI 3-Kinase and mTOR Pathway s. Histone Acetyl-Transferases and Deacetylases in the Con trol of Cell Proliferation and Differentiation. Molecular Pathogenesis o f Human Hepatocellular Carcinoma. The Cell Mediated Immune Response to Human Papillomavirus Induced Cervical Cancer: Implications for Immunotherapy. The T-cell Response in Patients with Ca ncer. The Life and Death of a B Cell.

Viruses, Cell Transformation, and Cancer, Volume 5 (Hardcover, 1st ed): J.A. Grand Viruses, Cell Transformation, and Cancer, Volume 5 (Hardcover, 1st ed)
J.A. Grand
R4,412 Discovery Miles 44 120 Ships in 12 - 19 working days

Viruses are the agent responsible for perhaps up to one million cases of cancer worldwide each year. Significantly, the study of viruses has also provided important clues to the causes and development of the most common human cancers. This volume presents an account of those viruses which have been directly associated with common human malignancies such as human papillomavirus (HPV), cervical carcinoma, Epstein-Barr virus (EBV) and Burkitt's lymphoma. In addition, the biology and biochemistry of those viruses which have been shown to be capable of transforming cells in culture are described in detail. Thus adenovirus are discussed, as are the other small DNA tumour viruses - Simian virus 40 (SV40) and polyoma virus. Consideration has also been given to human T-cell leukaemia virus (HTLV), hepatitis B virus (HBV) and human herpes virus 8 (HHV8), amongst others. General themes such as the host's immune response to viral infection, virally-induced apoptosis and the use of viruses as a delivery system in gene therapy have been discussed.
Individual chapters have been written by an international group of experts in their own field of research.

Research Advances in Leukemia (Hardcover): George Singer Research Advances in Leukemia (Hardcover)
George Singer
R2,521 Discovery Miles 25 210 Ships in 12 - 19 working days
Pulmonary Adenocarcinoma: Approaches to Treatment (Paperback): Leora Horn Pulmonary Adenocarcinoma: Approaches to Treatment (Paperback)
Leora Horn
R2,108 Discovery Miles 21 080 Ships in 12 - 19 working days

Get a quick, expert overview of the latest treatment and management approaches for adenocarcinoma of the lung, including novel therapeutics in immunotherapy and targeted therapies. This practical title, edited by Dr. Leora Horn, offers succinct coverage of clinically-focused topics and guidelines, making it an ideal resource for practicing and trainee oncologists and other members of the cancer care team. Discusses surgical approaches, molecular testing, adjuvant therapy, first- and second-line therapy, and much more. Helps you translate current research and literature into practical information for daily practice. Consolidates today's available information on this timely topic into one convenient resource.

Cell & Molecular Biology of Prostate Cancer - Updates, Insights and New Frontiers (Hardcover, 1st ed. 2018): Heide Schatten Cell & Molecular Biology of Prostate Cancer - Updates, Insights and New Frontiers (Hardcover, 1st ed. 2018)
Heide Schatten
R4,102 Discovery Miles 41 020 Ships in 10 - 15 working days

This volume covers classic and modern cell and molecular biology of prostate cancer, as well as novel biomarkers, inflammation, centrosome pathologies, microRNAs, cancer initiation novel biomarkers, inflammation, centrosome pathologies, microRNAs, cancer initiation and genetics, epigenetics, mitochondrial dysfunctions and apoptosis, cancer stem cells, angiogenesis and progression to metastasis, and treatment strategies including clinical trials related to prostate cancer. Cell & Molecular Biology of Prostate Cancer is one of two companion books comprehensively addressing the biology and clinical aspects of prostate cancer. Prostate Cancer: Molecular & Diagnostic Imaging and Treatment Stategies, the companion volume, discusses both classic and the most recent imaging approaches including analysis of needle biopsies, applications of nanoparticle probes and peptide-based radiopharmaceuticals for detection, early diagnosis and treatment of prostate cancer. Taken together, these volumes form one comprehensive and invaluable contribution to the literature.

Dietary Research and Cancer (Hardcover, 1st ed. 2021): Rajesh N. Gacche Dietary Research and Cancer (Hardcover, 1st ed. 2021)
Rajesh N. Gacche
R4,580 Discovery Miles 45 800 Ships in 12 - 19 working days

This book reviews all important aspects of dietary research associated with cancer with the aim of shedding new light on these conditions through combined understanding of traditional and new paradigms. The book is divided into 17 chapters, the first portion reinterprets healthy diets for cancer based on up-to-date evidence from a network science perspective, examining the dietary patterns, outcome of diet related clinical trials, emerging framework of molecular mechanisms and interactions of dietary interventions and their applications in personalized diet, ground realities of benefits and regulatory frame work for functional foods, nutraceuticals and supplements in cancer prevention and upcoming future prospectus in diet-cancer research.. The later part of the book discusses recent advances in understanding of the elaborative discourse on cancer and fasting, covering, for example, calorie restriction and fasting mimicking diet. Finally, different Dietary research and approaches are considered in the context of novel intervention for cancer research. Dietary Research in Cancer will be of interest for all researchers, nutritionists, students and clinicians in the field.

Advances in Cancer Research, Volume 84 (Hardcover): George Klein, George F. Vande Woude Advances in Cancer Research, Volume 84 (Hardcover)
George Klein, George F. Vande Woude
R3,823 Discovery Miles 38 230 Ships in 12 - 19 working days

The Advances in Cancer Research series provides invaluable information on the exciting and fast-moving field of cancer research. This volume presents outstanding and original reviews on a variety of topics, including gene expression in inherited breast cancer, multiparameter analyses of cell cycle regulation in tumorigenesis, Rho GTPases in transformation and metastasis, the myc oncogene, genetic requirements for the episomal maintenance of oncogenic herpesvirus genomes, treatment of Epstein-Barr virus-associated malignancies with specific T cells, the role of glycogen synthase kinase-3 in cancer, chronic immune activation and inflammation in the pathogenesis of AIDS and cancer, and molecular biology of Hodgkin's lymphoma.
* Gene Expression in Inherited Breast Cancer
* Multiparameter Analyses of CellCycle Regulatory Proteins in Human Breast Cancer: A Key to Definition of Separate Pathways in Tumorigenesis
* Rho GTPases in Transformation and Metastasis
* The "myc" Oncogene: Marvelously Complex
* Genetic Requirements for the Episomal Maintenance of Oncogenic Herpevirus Genomes
* Treatment of Epstein-Barr Virus-Associated Malignancies with Specific T Cells
* Role of Glycogen Synthase Kinase-3 in Cancer: Regulation Wnts and Other Signaling Pathways
* Chronic Immune Activation and Inflammation in the Pathogenesis of AIDS and Cancer
* Molecular Biology of Hodgkin's Lymphoma

Interventional Oncology - A Practical Guide for the Interventional Radiologist (Hardcover, 2012): Peter Mueller, Andreas Adam Interventional Oncology - A Practical Guide for the Interventional Radiologist (Hardcover, 2012)
Peter Mueller, Andreas Adam
R4,657 Discovery Miles 46 570 Ships in 10 - 15 working days

Interventional Oncology is a fast-growing new field, as well as an emerging specialty. Many minimally-invasive, imaging-guided procedures seem set to replace more traditional open surgical techniques of treating solid tumors in a variety of organs. The aim of this book is to describe new interventional radiological methods in a succinct and practical form. Diagnostic radiological considerations relevant to the selection and follow-up of patients are also covered. The book begins with an overview of the basic principles of current interventional techniques, including thermal ablation, high intensity focused ultrasound, and embolization. Later chapters focus on tumors of the liver, kidney, lung, and bone, placing new interventional techniques in context by referring to the surgical and oncologic methods of treating the same conditions. With an emphasis on best practices, Interventional Oncology: A Practical Guide for the Interventional Radiologist will serve as a definitive guide to practicing physicians involved in this rapidly evolving field.

Renal Cell Carcinoma: Research and Treatments (Hardcover): Barbara Mayer Renal Cell Carcinoma: Research and Treatments (Hardcover)
Barbara Mayer
R2,588 R2,356 Discovery Miles 23 560 Save R232 (9%) Ships in 10 - 15 working days
Protein Degradation in Health and Disease (Hardcover, illustrated edition): Michele Reboud-Ravaux Protein Degradation in Health and Disease (Hardcover, illustrated edition)
Michele Reboud-Ravaux
R3,095 Discovery Miles 30 950 Ships in 10 - 15 working days

Protein degradation has been identified as a major mechanism for the regulation of cellular functions. Not surprisingly, its deregulation is implied in almost any pathological condition. This book describes how aged proteins are eliminated during cell metabolism, how cell proliferation is regulated by protein degradation and how its deregulation can contribute to the development of cancer, how protein degradation is modified during normal and abnormal aging, in particular with regard to Alzheimer's disease and other degenerative diseases of the brain and central nervous system. Attempts aiming at correcting these pathologies by interfering with deviations of the normal pathway of protein degradation are also treated.

Novel Optical Endoscopes for Early Cancer Diagnosis and Therapy (Hardcover, 1st ed. 2019): Dale Jonathan Waterhouse Novel Optical Endoscopes for Early Cancer Diagnosis and Therapy (Hardcover, 1st ed. 2019)
Dale Jonathan Waterhouse
R2,873 Discovery Miles 28 730 Ships in 10 - 15 working days

This thesis describes the design, development, characterisation and clinical translation of three novel devices for optical endoscopic imaging. Over the past decade, rapid innovation in optics and photonics has led to the availability of low-cost and high-performance optical technologies that can be exploited for biomedical applications, but relatively few have been translated into clinic. The work presented outlines for the first time, a comprehensive analysis of the common barriers and unique challenges associated with the translation of optical imaging techniques. To assist developers streamline translation of optical imaging devices in future, a roadmap to clinical translation is outlined, and key translational characteristics are defined. Guided by these, subsequent development of endoscopic devices resulted in preparation and approval of endoscopes for first in human trials in the oesophagus, for early detection of cancer, and in the brain, for delineation of tumour during surgical resection. The thesis culminates in the presentation of results from the first in human use of a compact multispectral endoscope for imaging endogenous tissue contrast in the oesophagus. With continuation of the work as outlined at the end of this thesis, the novel techniques described have the potential to improve the standard of care in their respective indications.

VEGF and Cancer (Hardcover, 2004. Corr 2nd Printing ed.): Judith H. Harmey VEGF and Cancer (Hardcover, 2004. Corr 2nd Printing ed.)
Judith H. Harmey
R2,588 Discovery Miles 25 880 Ships in 12 - 19 working days

VEGF and Cancer is a comprehensive and up to date review of current knowledge on the role of vascular endothelial growth factor (VEGF) in cancer.
Key Features:
-Discussion of VEGF as potent angiogenic factor and its role in tumor angiogenesis,
-Review of the biology, molecular properties and regulation of VEGF,
-Discussion of the role of VEGF in a range of different tumor types, both solid tumors and haematological cancers,
-Review of the therapeutic potential of different approaches to block VEGF,
-Review of recent evidence that in addition to its role as an endothelial cell mitogen, VEGF may also be an autocrine growth factor for tumor cells, regulating survival and invasion.

This book is aimed at scientists new to angiogenesis and VEGF biology and provides new information for established researchers and scientists. It will also be a useful text for clinicians interested in anti-angiogenic therapy for treatment of human cancers.

Cervical Cancer - Screening, Treatment and Prevention - Universal Protocols for Ultimate Control (Hardcover): Rajamanickam... Cervical Cancer - Screening, Treatment and Prevention - Universal Protocols for Ultimate Control (Hardcover)
Rajamanickam Rajkumar
R3,315 Discovery Miles 33 150 Ships in 10 - 15 working days
Immune Checkpoint Inhibitors in Cancer (Paperback): Fumito Ito, Marc Ernstoff Immune Checkpoint Inhibitors in Cancer (Paperback)
Fumito Ito, Marc Ernstoff
R2,132 Discovery Miles 21 320 Ships in 12 - 19 working days

Get a quick, expert overview of the latest clinical information and guidelines for cancer checkpoint inhibitors and their implications for specific types of cancers. This practical title by Drs. Fumito Ito and Marc Ernstoff synthesizes the most up-to-date research and clinical guidance available on immune checkpoint inhibitors and presents this information in a compact, easy-to-digest resource. It's an ideal concise reference for trainee and practicing medical oncologists, as well as those in research. Discusses the current understanding of how to best harness the immune system against different types of cancer at various stages. Helps you translate current research and literature into practical information for daily practice. Presents information logically organized by disease site. Covers tumor immunology and biology; toxicities associated with immune checkpoint inhibitors; and future outlooks. Consolidates today's available information on this timely topic into one convenient resource.

Anticancer Drug Development (Hardcover): Bruce C. Baguley, David J. Kerr Anticancer Drug Development (Hardcover)
Bruce C. Baguley, David J. Kerr
R3,181 Discovery Miles 31 810 Ships in 12 - 19 working days

Here in a single source is a complete spectrum of ideas on the development of new anticancer drugs. Containing concise reviews of multidisciplinary fields of research, this book offers a wealth of ideas on current and future molecular targets for drug design, including signal transduction, the cell division cycle, and programmed cell death. Detailed descriptions of sources for new drugs and methods for testing and clinical trial design are also provided.
KEY FEATURES:
* One work that can be consulted for all aspects of anticancer drug development
* Concise reviews of research fields, combined with practical scientific detail, written by internationally respected experts
* A wealth of ideas on current and future molecular targets for drug design, including signal transduction, the cell division cycle, and programmed cell death
* Detailed descriptions of the sources of new anticancer drugs, including combinatorial chemistry, phage display, and natural products
* Discussion of how new drugs can be tested in preclinical systems, including the latest technology of robotic assay systems, cell culture, and experimental animal techniques
* Hundreds of references that allow the reader to access relevant scientific and medical literature
* Clear illustrations, some in color, that provide both understanding of the field and material for teaching

Evidence and Hypothesis in Clinical Medical Science (Hardcover, 1st ed. 2020): John Alexander Pinkston Evidence and Hypothesis in Clinical Medical Science (Hardcover, 1st ed. 2020)
John Alexander Pinkston
R2,259 Discovery Miles 22 590 Ships in 10 - 15 working days

In this book, the author argues that no current philosophical theory of evidence in clinical medical science is adequate. None can accurately explain the way evidence is gathered and used to confirm hypotheses. To correct this, he proposes a new approach called the weight of evidence account. This innovative method supplies a satisfactory explanation and rationale for the "hierarchical pyramid" of evidence-based medicine, with randomized clinical trials and their derivatives, meta-analyses, and systematic reviews of randomized clinical trials at the top and case reports, case series, expert opinion, and the like at the bottom. The author illustrates the development of various "levels" of evidence by considering the evolution of less invasive surgical treatments for early breast cancer. He shows that the weight of evidence account explains the notion of levels of evidence and other efforts to rank them. In addition, he presents a defense of randomization as a method to maximize accuracy in the conduct of clinical trials. The title also considers ethical issues surrounding experimentation with medical therapies in human subjects. It illustrates and discusses these issues in studies of respiratory therapies in neonates and treatment for certain cancers in adults. The author shows that in many cases sufficient evidence can be accrued to warrant generally accepted new therapies without the need for evidence derived from randomized clinical trials.

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