Androstenols are a type of steroid compound that is found in both animals and humans. They are classified as pheromones, which are chemicals that can affect the behavior or physiology of other members of the same species. Androstenols are found in high concentrations in male sweat, and they have been suggested to play a role in human sexual attraction and communication.

In particular, androstenols are thought to have a positive and calming effect on people, and may help to reduce stress and anxiety. They have also been shown to increase feelings of approachability and friendliness between individuals. Some studies have suggested that androstenols may be particularly effective at enhancing social interactions in women.

Androstenols are often used in perfumes and colognes, as well as in aromatherapy products, because of their potential to promote positive social interactions and reduce stress. However, it is important to note that the effects of androstenols on human behavior and physiology are still not fully understood, and more research is needed to confirm their role in human communication and attraction.

Phenytoin is an anticonvulsant drug, which is chemically classified as a hydantoin. The term "phenylthiohydantoin" refers to the functional group that makes up the core structure of phenytoin and other related compounds. This group consists of a phenyl ring (a benzene ring with a hydrogen atom replaced by a hydrocarbon group) attached to a thiocarbonyl group (-C=S), which is in turn attached to a hydantoin ring.

The hydantoin ring is a six-membered ring containing two nitrogen atoms and two carbonyl groups, which makes it a cyclic urea derivative. Phenytoin's chemical formula is C15H14N2O2S, and its molecular structure can be represented as follows:


Phenytoin is primarily used as an antiepileptic drug to control tonic-clonic (grand mal) and complex partial seizures. It works by stabilizing the inactive state of voltage-gated sodium channels in the brain, which reduces their excitability and helps prevent abnormal electrical activity leading to seizures.

In a medical context, "phenylthiohydantoin" is not typically used as a standalone definition but rather refers to the core structure of phenytoin and related compounds.

Steroid 17-alpha-hydroxylase, also known as CYP17A1, is a cytochrome P450 enzyme that plays a crucial role in steroid hormone biosynthesis. It is located in the endoplasmic reticulum of cells in the adrenal glands and gonads. This enzyme catalyzes the 17-alpha-hydroxylation and subsequent lyase cleavage of pregnenolone and progesterone, converting them into dehydroepiandrosterone (DHEA) and androstenedione, respectively. These steroid intermediates are essential for the biosynthesis of both glucocorticoids and sex steroids, including cortisol, aldosterone, estrogens, and testosterone.

Defects in the CYP17A1 gene can lead to several disorders, such as congenital adrenal hyperplasia (CAH) due to 17-alpha-hydroxylase deficiency, which is characterized by decreased production of cortisol and sex steroids and increased mineralocorticoid levels. This condition results in sexual infantilism, electrolyte imbalances, and hypertension.

Orchiectomy is a surgical procedure where one or both of the testicles are removed. It is also known as castration. This procedure can be performed for various reasons, including the treatment of testicular cancer, prostate cancer, or other conditions that may affect the testicles. It can also be done to reduce levels of male hormones in the body, such as in the case of transgender women undergoing gender affirming surgery. The specific medical definition may vary slightly depending on the context and the extent of the procedure.

Castration-resistant prostate cancer (CRPC) is a more advanced form of prostate cancer that no longer responds to treatments that lower levels of male hormones, such as orchiectomy (surgical removal of the testicles) or medical castration with luteinizing hormone-releasing hormone (LHRH) agonists or antagonists. Despite these interventions, the cancer continues to progress and grow. This is often due to the development of mechanisms that allow the cancer cells to produce their own male hormones or become less dependent on them for growth and survival. CRPC is a complex and heterogeneous disease with various clinical manifestations and treatment options, which may include chemotherapy, novel hormonal therapies, immunotherapy, and/or radiation therapy.

Androgen antagonists are a class of drugs that block the action of androgens, which are hormones that contribute to male sexual development and characteristics. They work by binding to androgen receptors in cells, preventing the natural androgens from attaching and exerting their effects. This can be useful in treating conditions that are caused or worsened by androgens, such as prostate cancer, hirsutism (excessive hair growth in women), and acne. Examples of androgen antagonists include flutamide, bicalutamide, and spironolactone.

Prostatic neoplasms refer to abnormal growths in the prostate gland, which can be benign or malignant. The term "neoplasm" simply means new or abnormal tissue growth. When it comes to the prostate, neoplasms are often referred to as tumors.

Benign prostatic neoplasms, such as prostate adenomas, are non-cancerous overgrowths of prostate tissue. They usually grow slowly and do not spread to other parts of the body. While they can cause uncomfortable symptoms like difficulty urinating, they are generally not life-threatening.

Malignant prostatic neoplasms, on the other hand, are cancerous growths. The most common type of prostate cancer is adenocarcinoma, which arises from the glandular cells in the prostate. Prostate cancer often grows slowly and may not cause any symptoms for many years. However, some types of prostate cancer can be aggressive and spread quickly to other parts of the body, such as the bones or lymph nodes.

It's important to note that while prostate neoplasms can be concerning, early detection and treatment can significantly improve outcomes for many men. Regular check-ups with a healthcare provider are key to monitoring prostate health and catching any potential issues early on.

Castration is a surgical procedure to remove the testicles in males or ovaries in females. In males, it is also known as orchiectomy. This procedure results in the inability to produce sex hormones and gametes (sperm in men and eggs in women), and can be done for various reasons such as medical treatment for certain types of cancer, to reduce sexual urges in individuals with criminal tendencies, or as a form of birth control in animals.

Androstadienes are a class of steroid hormones that are derived from androstenedione, which is a weak male sex hormone. Androstadienes include various compounds such as androstadiene-3,17-dione and androstanedione, which are intermediate products in the biosynthesis of more potent androgens like testosterone and dihydrotestosterone.

Androstadienes are present in both males and females but are found in higher concentrations in men. They can be detected in various bodily fluids, including blood, urine, sweat, and semen. In addition to their role in steroid hormone synthesis, androstadienes have been studied for their potential use as biomarkers of physiological processes and disease states.

It's worth noting that androstadienes are sometimes referred to as "androstenes" in the literature, although this term can also refer to other related compounds.

Acetates, in a medical context, most commonly refer to compounds that contain the acetate group, which is an functional group consisting of a carbon atom bonded to two hydrogen atoms and an oxygen atom (-COO-). An example of an acetate is sodium acetate (CH3COONa), which is a salt formed from acetic acid (CH3COOH) and is often used as a buffering agent in medical solutions.

Acetates can also refer to a group of medications that contain acetate as an active ingredient, such as magnesium acetate, which is used as a laxative, or calcium acetate, which is used to treat high levels of phosphate in the blood.

In addition, acetates can also refer to a process called acetylation, which is the addition of an acetyl group (-COCH3) to a molecule. This process can be important in the metabolism and regulation of various substances within the body.

Androgens are a class of hormones that are primarily responsible for the development and maintenance of male sexual characteristics and reproductive function. Testosterone is the most well-known androgen, but other androgens include dehydroepiandrosterone (DHEA), androstenedione, and dihydrotestosterone (DHT).

Androgens are produced primarily by the testes in men and the ovaries in women, although small amounts are also produced by the adrenal glands in both sexes. They play a critical role in the development of male secondary sexual characteristics during puberty, such as the growth of facial hair, deepening of the voice, and increased muscle mass.

In addition to their role in sexual development and function, androgens also have important effects on bone density, mood, and cognitive function. Abnormal levels of androgens can contribute to a variety of medical conditions, including infertility, erectile dysfunction, acne, hirsutism (excessive hair growth), and prostate cancer.

Prostate-Specific Antigen (PSA) is a glycoprotein enzyme produced by the epithelial cells of the prostate gland. It is primarily involved in liquefying semen after ejaculation, allowing sperm mobility.

In clinical medicine, PSA is used as a tumor marker, mainly for monitoring the treatment and recurrence of prostate cancer. Elevated levels of PSA can indicate inflammation, infection, benign prostatic hyperplasia (BPH), or prostate cancer. However, it's important to note that an elevated PSA level does not necessarily confirm cancer; further diagnostic tests like digital rectal examination, transrectal ultrasound, and prostate biopsy are often required for definitive diagnosis.

Doctors may also use PSA isoforms or derivatives, such as free PSA, total PSA, and PSA density, to help improve the specificity of cancer detection and differentiate between malignant and benign conditions.

Hormone-dependent neoplasms are a type of tumor that requires the presence of specific hormones to grow and multiply. These neoplasms have receptors on their cell surfaces that bind to the hormones, leading to the activation of signaling pathways that promote cell division and growth.

Examples of hormone-dependent neoplasms include breast cancer, prostate cancer, and endometrial cancer. In breast cancer, for instance, estrogen and/or progesterone can bind to their respective receptors on the surface of cancer cells, leading to the activation of signaling pathways that promote tumor growth. Similarly, in prostate cancer, androgens such as testosterone can bind to androgen receptors on the surface of cancer cells, promoting cell division and tumor growth.

Hormone-dependent neoplasms are often treated with hormonal therapies that aim to reduce or block the production of the relevant hormones or interfere with their ability to bind to their respective receptors. This can help slow down or stop the growth of the tumor and improve outcomes for patients.

Taxoids are a class of naturally occurring compounds that are derived from the bark of the Pacific yew tree (Taxus brevifolia) and other species of the genus Taxus. They are known for their antineoplastic (cancer-fighting) properties and have been used in chemotherapy to treat various types of cancer, including ovarian, breast, and lung cancer.

The most well-known taxoid is paclitaxel (also known by the brand name Taxol), which was first discovered in the 1960s and has since become a widely used cancer drug. Paclitaxel works by stabilizing microtubules, which are important components of the cell's skeleton, and preventing them from disassembling. This disrupts the normal function of the cell's mitotic spindle, leading to cell cycle arrest and ultimately apoptosis (programmed cell death).

Other taxoids that have been developed for clinical use include docetaxel (Taxotere), which is a semi-synthetic analogue of paclitaxel, and cabazitaxel (Jevtana), which is a second-generation taxoid. These drugs have similar mechanisms of action to paclitaxel but may have different pharmacokinetic properties or be effective against cancer cells that have developed resistance to other taxoids.

While taxoids have been successful in treating certain types of cancer, they can also cause significant side effects, including neutropenia (low white blood cell count), anemia (low red blood cell count), and peripheral neuropathy (nerve damage). As with all chemotherapy drugs, the use of taxoids must be carefully balanced against their potential benefits and risks.

Antineoplastic agents, hormonal, are a class of drugs used to treat cancers that are sensitive to hormones. These agents work by interfering with the production or action of hormones in the body. They can be used to slow down or stop the growth of cancer cells and may also help to relieve symptoms caused by the spread of cancer.

Hormonal therapies can work in one of two ways: they can either block the production of hormones or prevent their action on cancer cells. For example, some hormonal therapies work by blocking the action of estrogen or testosterone, which are hormones that can stimulate the growth of certain types of cancer cells.

Examples of hormonal agents used to treat cancer include:

* Aromatase inhibitors (such as letrozole, anastrozole, and exemestane), which block the production of estrogen in postmenopausal women
* Selective estrogen receptor modulators (such as tamoxifen and raloxifene), which block the action of estrogen on cancer cells
* Luteinizing hormone-releasing hormone agonists (such as leuprolide, goserelin, and triptorelin), which block the production of testosterone in men
* Antiandrogens (such as bicalutamide, flutamide, and enzalutamide), which block the action of testosterone on cancer cells

Hormonal therapies are often used in combination with other treatments, such as surgery or radiation therapy. They may be used to shrink tumors before surgery, to kill any remaining cancer cells after surgery, or to help control the spread of cancer that cannot be removed by surgery. Hormonal therapies can also be used to relieve symptoms and improve quality of life in people with advanced cancer.

It's important to note that hormonal therapies are not effective for all types of cancer. They are most commonly used to treat breast, prostate, and endometrial cancers, which are known to be sensitive to hormones. Hormonal therapies may also be used to treat other types of cancer in certain situations.

Like all medications, hormonal therapies can have side effects. These can vary depending on the specific drug and the individual person. Common side effects of hormonal therapies include hot flashes, fatigue, mood changes, and sexual dysfunction. Some hormonal therapies can also cause more serious side effects, such as an increased risk of osteoporosis or blood clots. It's important to discuss the potential risks and benefits of hormonal therapy with a healthcare provider before starting treatment.

Prednisone is a synthetic glucocorticoid, which is a type of corticosteroid hormone. It is primarily used to reduce inflammation in various conditions such as asthma, allergies, arthritis, and autoimmune disorders. Prednisone works by mimicking the effects of natural hormones produced by the adrenal glands, suppressing the immune system's response and reducing the release of substances that cause inflammation.

It is available in oral tablet form and is typically prescribed to be taken at specific times during the day, depending on the condition being treated. Common side effects of prednisone include increased appetite, weight gain, mood changes, insomnia, and easy bruising. Long-term use or high doses can lead to more serious side effects such as osteoporosis, diabetes, cataracts, and increased susceptibility to infections.

Healthcare providers closely monitor patients taking prednisone for extended periods to minimize the risk of adverse effects. It is essential to follow the prescribed dosage regimen and not discontinue the medication abruptly without medical supervision, as this can lead to withdrawal symptoms or a rebound of the underlying condition.

Antineoplastic agents are a class of drugs used to treat malignant neoplasms or cancer. These agents work by inhibiting the growth and proliferation of cancer cells, either by killing them or preventing their division and replication. Antineoplastic agents can be classified based on their mechanism of action, such as alkylating agents, antimetabolites, topoisomerase inhibitors, mitotic inhibitors, and targeted therapy agents.

Alkylating agents work by adding alkyl groups to DNA, which can cause cross-linking of DNA strands and ultimately lead to cell death. Antimetabolites interfere with the metabolic processes necessary for DNA synthesis and replication, while topoisomerase inhibitors prevent the relaxation of supercoiled DNA during replication. Mitotic inhibitors disrupt the normal functioning of the mitotic spindle, which is essential for cell division. Targeted therapy agents are designed to target specific molecular abnormalities in cancer cells, such as mutated oncogenes or dysregulated signaling pathways.

It's important to note that antineoplastic agents can also affect normal cells and tissues, leading to various side effects such as nausea, vomiting, hair loss, and myelosuppression (suppression of bone marrow function). Therefore, the use of these drugs requires careful monitoring and management of their potential adverse effects.

Androgen receptors (ARs) are a type of nuclear receptor protein that are expressed in various tissues throughout the body. They play a critical role in the development and maintenance of male sexual characteristics and reproductive function. ARs are activated by binding to androgens, which are steroid hormones such as testosterone and dihydrotestosterone (DHT). Once activated, ARs function as transcription factors that regulate gene expression, ultimately leading to various cellular responses.

In the context of medical definitions, androgen receptors can be defined as follows:

Androgen receptors are a type of nuclear receptor protein that bind to androgens, such as testosterone and dihydrotestosterone, and mediate their effects on gene expression in various tissues. They play critical roles in the development and maintenance of male sexual characteristics and reproductive function, and are involved in the pathogenesis of several medical conditions, including prostate cancer, benign prostatic hyperplasia, and androgen deficiency syndromes.

Treatment outcome is a term used to describe the result or effect of medical treatment on a patient's health status. It can be measured in various ways, such as through symptoms improvement, disease remission, reduced disability, improved quality of life, or survival rates. The treatment outcome helps healthcare providers evaluate the effectiveness of a particular treatment plan and make informed decisions about future care. It is also used in clinical research to compare the efficacy of different treatments and improve patient care.

Androgen receptor antagonists are a class of drugs that block the action of androgens, which are hormones responsible for the development and maintenance of male sexual characteristics. These drugs work by binding to the androgen receptors in cells, preventing the natural androgens such as testosterone and dihydrotestosterone from binding and exerting their effects.

Androgen receptor antagonists are often used in the treatment of prostate cancer because androgens can stimulate the growth of prostate cancer cells. By blocking the action of androgens, these drugs can help to slow or stop the growth of prostate cancer tumors. Some examples of androgen receptor antagonists include flutamide, bicalutamide, and enzalutamide.

It's important to note that androgen receptor antagonists can have side effects, including hot flashes, breast tenderness or enlargement, decreased sex drive, and impotence. Additionally, long-term use of these drugs can lead to muscle loss, bone density loss, and an increased risk of fractures. As with any medication, it's important to discuss the potential benefits and risks with a healthcare provider before starting treatment.

Tetradecanoylphorbol acetate (TPA) is defined as a pharmacological agent that is a derivative of the phorbol ester family. It is a potent tumor promoter and activator of protein kinase C (PKC), a group of enzymes that play a role in various cellular processes such as signal transduction, proliferation, and differentiation. TPA has been widely used in research to study PKC-mediated signaling pathways and its role in cancer development and progression. It is also used in topical treatments for skin conditions such as psoriasis.

Biosynthetic pathways refer to the series of biochemical reactions that occur within cells and living organisms, leading to the production (synthesis) of complex molecules from simpler precursors. These pathways involve a sequence of enzyme-catalyzed reactions, where each reaction builds upon the product of the previous one, ultimately resulting in the formation of a specific biomolecule.

Examples of biosynthetic pathways include:

1. The Krebs cycle (citric acid cycle) - an essential metabolic pathway that generates energy through the oxidation of acetyl-CoA derived from carbohydrates, fats, and proteins.
2. Glycolysis - a process that breaks down glucose into pyruvate to generate ATP and NADH.
3. Gluconeogenesis - the synthesis of glucose from non-carbohydrate precursors such as lactate, pyruvate, glycerol, and certain amino acids.
4. Fatty acid synthesis - a process that produces fatty acids from acetyl-CoA and malonyl-CoA through a series of reduction reactions.
5. Amino acid synthesis - the production of various amino acids from simpler precursors, often involving intermediates in central metabolic pathways like the Krebs cycle or glycolysis.
6. Steroid biosynthesis - the formation of steroids from simple precursors such as cholesterol and its derivatives.
7. Terpenoid biosynthesis - the production of terpenes, terpenoids, and sterols from isoprene units (isopentenyl pyrophosphate).
8. Nucleotide synthesis - the generation of nucleotides, the building blocks of DNA and RNA, through complex biochemical pathways involving various precursors and cofactors.

Understanding biosynthetic pathways is crucial for comprehending cellular metabolism, developing drugs that target specific metabolic processes, and engineering organisms with desired traits in synthetic biology and metabolic engineering applications.

Tissue extracts refer to the substances or compounds that are extracted from various types of biological tissues, such as plants, animals, or microorganisms. These extracts contain bioactive molecules, including proteins, peptides, lipids, carbohydrates, nucleic acids, and other small molecules, which can have therapeutic or diagnostic potential. The process of tissue extraction involves homogenizing the tissue, followed by separation and purification of the desired components using various techniques such as centrifugation, filtration, chromatography, or precipitation.

In medical research and clinical settings, tissue extracts are often used to study the biochemical and molecular properties of cells and tissues, investigate disease mechanisms, develop diagnostic tests, and identify potential drug targets. Examples of tissue extracts include cell lysates, subcellular fractions, organelle preparations, plasma membrane extracts, nuclear extracts, and various types of protein or nucleic acid extracts. It is important to note that the quality and purity of tissue extracts can significantly impact the accuracy and reproducibility of experimental results, and appropriate controls and validation methods should be employed to ensure their proper use.

Phase III clinical trials are a type of medical research study that involves testing the safety and efficacy of a new drug, device, or treatment in a large group of people. These studies typically enroll hundreds to thousands of participants, who are randomly assigned to receive either the experimental treatment or a standard of care comparison group.

The primary goal of Phase III clinical trials is to determine whether the new treatment works better than existing treatments and to assess its safety and side effects in a larger population. The data collected from these studies can help regulatory agencies like the U.S. Food and Drug Administration (FDA) decide whether to approve the new treatment for use in the general population.

Phase III clinical trials are usually conducted at multiple centers, often across different countries, to ensure that the results are generalizable to a wide range of patients. Participants may be followed for several years to assess long-term safety and efficacy outcomes.

Overall, Phase III clinical trials play a critical role in ensuring that new treatments are safe and effective before they become widely available to patients.

In medical terminology, a budget is not explicitly defined. However, in a general sense, it refers to a financial plan that outlines the anticipated costs and expenses for a specific period. In healthcare, budgets can be used by hospitals, clinics, or other medical facilities to plan for and manage their finances.

A healthcare organization's budget may include expenses related to:

* Salaries and benefits for staff
* Equipment and supply costs
* Facility maintenance and improvements
* Research and development expenses
* Insurance and liability coverage
* Marketing and advertising costs

Budgets can help healthcare organizations manage their finances effectively, allocate resources efficiently, and make informed decisions about spending. They may also be used to plan for future growth and expansion.

Drug resistance in neoplasms (also known as cancer drug resistance) refers to the ability of cancer cells to withstand the effects of chemotherapeutic agents or medications designed to kill or inhibit the growth of cancer cells. This can occur due to various mechanisms, including changes in the cancer cell's genetic makeup, alterations in drug targets, increased activity of drug efflux pumps, and activation of survival pathways.

Drug resistance can be intrinsic (present at the beginning of treatment) or acquired (developed during the course of treatment). It is a significant challenge in cancer therapy as it often leads to reduced treatment effectiveness, disease progression, and poor patient outcomes. Strategies to overcome drug resistance include the use of combination therapies, development of new drugs that target different mechanisms, and personalized medicine approaches that consider individual patient and tumor characteristics.

Acetate kinase is an enzyme that catalyzes the reversible phosphorylation of acetate to form acetyl phosphate and ADP (adenosine diphosphate) from ATP (adenosine triphosphate). The reaction is as follows:

Acetate + ATP -> Acetyl phosphate + ADP

This enzyme plays a role in the metabolism of certain bacteria and archaea, where it helps to generate energy in the form of ATP. It is not typically found in humans or other mammals.

Dihydrotestosterone (DHT) is a sex hormone and androgen that plays a critical role in the development and maintenance of male characteristics, such as facial hair, deep voice, and muscle mass. It is synthesized from testosterone through the action of the enzyme 5-alpha reductase. DHT is essential for the normal development of the male genitalia during fetal development and for the maturation of the sexual organs at puberty.

In addition to its role in sexual development, DHT also contributes to the growth of hair follicles, the health of the prostate gland, and the maintenance of bone density. However, an excess of DHT has been linked to certain medical conditions, such as benign prostatic hyperplasia (BPH) and androgenetic alopecia (male pattern baldness).

DHT exerts its effects by binding to androgen receptors in various tissues throughout the body. Once bound, DHT triggers a series of cellular responses that regulate gene expression and influence the growth and differentiation of cells. In some cases, these responses can lead to unwanted side effects, such as hair loss or prostate enlargement.

Medications that block the action of 5-alpha reductase, such as finasteride and dutasteride, are sometimes used to treat conditions associated with excess DHT production. These drugs work by reducing the amount of DHT available to bind to androgen receptors, thereby alleviating symptoms and slowing disease progression.

In summary, dihydrotestosterone is a potent sex hormone that plays a critical role in male sexual development and function. While it is essential for normal growth and development, an excess of DHT has been linked to certain medical conditions, such as BPH and androgenetic alopecia. Medications that block the action of 5-alpha reductase are sometimes used to treat these conditions by reducing the amount of DHT available to bind to androgen receptors.

An encyclopedia is a comprehensive reference work containing articles on various topics, usually arranged in alphabetical order. In the context of medicine, a medical encyclopedia is a collection of articles that provide information about a wide range of medical topics, including diseases and conditions, treatments, tests, procedures, and anatomy and physiology. Medical encyclopedias may be published in print or electronic formats and are often used as a starting point for researching medical topics. They can provide reliable and accurate information on medical subjects, making them useful resources for healthcare professionals, students, and patients alike. Some well-known examples of medical encyclopedias include the Merck Manual and the Stedman's Medical Dictionary.

Ketoconazole is an antifungal medication that is primarily used to treat various fungal infections, including those caused by dermatophytes, Candida, and pityrosporum. It works by inhibiting the synthesis of ergosterol, a crucial component of fungal cell membranes, which leads to increased permeability and ultimately results in fungal cell death.

Ketoconazole is available as an oral tablet for systemic use and as a topical cream or shampoo for localized applications. The oral formulation is used to treat severe or invasive fungal infections, while the topical preparations are primarily indicated for skin and scalp infections, such as athlete's foot, ringworm, jock itch, candidiasis, and seborrheic dermatitis.

Common side effects of oral ketoconazole include nausea, vomiting, headache, and altered liver function tests. Rare but serious adverse reactions may include hepatotoxicity, adrenal insufficiency, and interactions with other medications that can affect the metabolism and elimination of drugs. Topical ketoconazole is generally well-tolerated, with local irritation being the most common side effect.

It's important to note that due to its potential for serious liver toxicity and drug-drug interactions, oral ketoconazole has been largely replaced by other antifungal agents, such as fluconazole and itraconazole, which have more favorable safety profiles. Topical ketoconazole remains a valuable option for treating localized fungal infections due to its effectiveness and lower risk of systemic side effects.