This randomized trial of treatment for advanced laryngeal cancer found that concurrent chemotherapy and radiotherapy was superior to chemotherapy followed by radiotherapy or radiotherapy alone.

In 1991, the Journal published a landmark study in which chemotherapy followed by radiotherapy was shown to make laryngectomy unnecessary in patients with laryngeal cancer. The current investigation refined the protocol by showing that laryngeal preservation is best achieved by treatment with concomitant chemotherapy plus radiotherapy.

In this randomized, placebo-controlled trial involving premature infants (less than 34 weeks' gestation) with the respiratory distress syndrome, the use of inhaled nitric oxide significantly reduced the incidence of chronic lung disease and death. This therapy also reduced the rate of severe intraventricular hemorrhage and periventricular leukomalacia — important complications of prematurity.

Inhaled nitric oxide may benefit premature infants with the respiratory distress syndrome.

Lp(a) lipoprotein is a variant of low-density lipoprotein cholesterol and is important in the pathogenesis of atherothrombotic disease. This study focused on Lp(a) lipoprotein as a risk factor for stroke, death from vascular causes, and overall mortality in elderly men and women. The Lp(a) lipoprotein level was an independent predictor of these end points in men but not in women.

Measurement of Lp(a) lipoprotein may have value in predicting vascular events in older men but not in older women.

Research has demonstrated that there is lower operative mortality at hospitals with higher surgical volume. Using administrative data from Medicare, this study found lower mortality associated with each of eight procedures when performed by surgeons who undertook the operation more frequently.

Quality-improvement initiatives are directing patients to hospitals with higher volumes of surgical procedures. The volume of procedures performed by individual surgeons is another important determinant of surgical mortality.

Many conditions other than acute myocardial infarction cause elevation of ST segments on an electrocardiogram. This review explains the conditions that may mimic acute myocardial infarction electrocardiographically. Because decisions about reperfusion therapy must be made quickly for patients with myocardial infarction, it is important to recognize and differentiate other causes of ST-segment elevation.

Irritable bowel syndrome, characterized by disordered bowel habits associated with abdominal pain or discomfort, affects roughly one in eight adults. This review discusses therapeutic options for patients with this disorder. Nonpharmacologic therapies alone are adequate for many patients. Nonspecific pharmacotherapy to treat constipation or diarrhea, as well as more specific therapy with antispasmodic agents, antidepressants, serotonin-receptor antagonists, and other agents are discussed. A doctor–patient alliance is important in treating the disorder.

Rapid, accurate detection of pathogens is essential to managing disease. A recent study shows that genetically modified B lymphocytes represent a promising tool for identifying pathogens quickly.