Diabetic retinal disease is envisioned to become the plague of the coming decades with a steep increase of worldwide diabetes incidence followed by a substantial rise in retinal disease. Improvements in diagnostic and therapeutic care have to cope with this dilemma in a clinically and socioeconomically efficient manner. Laser treatment has found a less destructive competitor in pharmacological treatments. As a consequence of recent rigorous clinical trials, laser photocoagulation is no longer recommended for the treatment of diabetic macular edema (DME), and anti-vascular endothelial growth factor therapy has emerged as first-line therapy. Steroids have maintained a role in the management of chronically persistent DME. The paradigm shifts in therapy are accompanied by a substantial break-through in diagnostics. The following guidance for the management of DME has been composed from the best updated knowledge of leading experts in Europe and represents another volume in the series of EURETINA recommendations for the management of retinal disease.

Accurate measurement of antiretroviral adherence is essential for targeting and rigorously evaluating interventions to improve adherence and prevent viral resistance. Across diseases, medication adherence is an individual, complex, and dynamic human behavior that presents unique measurement challenges. Measurement of medication adherence is further complicated by the diversity of available measures, which have different utility in clinical and research settings. Limited understanding of how to optimize existing adherence measures has hindered progress in adherence research in both HIV and other diseases. Though self-report is the most widely used adherence measure and the most promising for use in clinical care and resource limited settings, adherence researchers have yet to develop evidence-based standards for self-reported adherence. In addition, the use of objective measures, such as electronic drug monitoring or pill counts, is limited by poor understanding of the source and magnitude of error biasing these measures. To address these limitations, research is needed to evaluate methods of combining information from different measures. The goals of this review are to describe the state of the science of adherence measurement, to discuss the advantages and disadvantages of common adherence measurement methods, and to recommend directions for improving antiretroviral adherence measurement in research and clinical care.

Colony‐stimulating factor‐1 (CSF‐1), also known as macrophage colony‐stimulating factor, controls the survival, proliferation, and differentiation of mono‐nuclear phagocytes and regulates cells of the female reproductive tract. It appears to play an autocrine and/or paracrine role in cancers of the ovary, endometrium, breast, and myeloid and lymphoid tissues. Through alternative mRNA splicing and differential post‐translational proteolytic processing, CSF‐1 can either be secreted into the circulation as a glycoprotein or chondroitin sulfate‐containing proteoglycan or be expressed as a membrane‐spanning glycoprotein on the surface of CSF‐1‐producing cells. Studies with the op/op mouse, which possesses an inactivating mutation in the CSF‐1 gene, have established the central role of CSF‐1 in directly regulating osteoclastogenesis and macrophage production. CSF‐1 appears to preferentially regulate the development of macrophages found in tissues undergoing active morphogenesis and/or tissue remodeling. These CSF‐1 dependent macrophages may, via putative trophic and/or scavenger functions, regulate characteristics such as dermal thickness, male fertility, and neural processing. Apart from its expression on mononuclear phagocytes and their precursors, CSF‐1 receptor (CSF‐1R) expression on certain nonmononuclear phagocytic cells in the female reproductive tract and studies in the op/op mouse indicate that CSF‐1 plays important roles in female reproduction. Restoration of circulating CSF‐1 to op/op mice has preliminarily defined target cell populations that are regulated either humorally or locally by the synthesis of cell‐surface CSF‐1 or by sequestration of the CSF‐1 proteoglycan. The CSF‐1R is a tyrosine kinase encoded by the c‐fms proto‐oncogene product. Studies by several groups have used cells expressing either the murine or human CSF‐1R in fibroblasts to pinpoint the requirement of kinase activity and the importance of various receptor tyrosine phosphorylation sites for signaling pathways stimulated by CSF‐1. To investigate post‐CSF‐1R signaling in the macrophage, proteins that are rapidly phosphorylated on tyrosine in response to CSF‐1 have been identified, together with proteins associated with them. Studies on several of these proteins, including protein tyrosine phosphatase 1C, the c‐cbl proto‐oncogene product, and protein tyrosine phosphatase‐phi are discussed. Mol Reprod Dev 46:4–10, 1997. © 1997 Wiley‐Liss, Inc.