This study compared moderate lipid lowering with pravastatin and intensive lipid lowering with atorvastatin in patients after an acute coronary syndrome. Over a mean follow-up period of two years, those treated with the intensive lipid-lowering regimen had better outcomes.

The findings add to a growing body of evidence supporting the use of intensive lipid lowering to prevent cardiovascular events. The current recommended target levels for low-density lipoprotein cholesterol in persons at risk may need to be lowered.

Low levels of high-density lipoprotein (HDL) cholesterol increase the risk of coronary heart disease. The authors of this study investigated a novel method of raising HDL cholesterol levels. Torcetrapib is a potent inhibitor of cholesteryl ester transfer protein, a plasma glycoprotein that conveys cholesteryl esters from HDL to low-density lipoprotein (LDL). Over the main four-week study period, this drug markedly increased levels of HDL cholesterol, whether or not the patient was also taking atorvastatin to lower LDL cholesterol.

Torcetrapib shows promise, but this preliminary study must be followed up with long-term assessments of safety and clinical efficacy.

Hypercalcemia and hyperphosphatemia often complicate secondary hyperparathyroidism therapy in patients who are receiving dialysis. Unlike vitamin D and calcium, calcimimetic agents target the calcium-sensing receptor. This study reports the safety and effectiveness of the calcimimetic agent cinacalcet in patients receiving dialysis who had uncontrolled hyperparathyroidism. The mean parathyroid hormone values decreased 43 percent with cinacalcet therapy but increased 9 percent with placebo, and the calcium–phosphorus product declined with cinacalcet but not placebo.

Cinacalcet appears to lower plasma parathyroid hormone levels in patients receiving hemodialysis while improving calcium–phosphorus homeostasis.

A 45-year-old fair-skinned woman has noted increasing sallowness, roughness, fine wrinkles, and mottled hyperpigmentation on her face. She is bothered by these changes and is worried about the development of nonmelanoma skin cancer. What treatments may minimize skin aging and lower the risk of skin cancer?

This comprehensive survey emphasizes how recent advances in the knowledge of molecular mechanisms involved in acute lymphoblastic leukemia have influenced diagnosis, prognosis, and treatment.

A 12-year-old boy was admitted to the hospital with a two-day history of a rash and of swelling of the face, hands, and feet. On admission, he was afebrile and hypertensive, with pitting edema of the legs. Laboratory studies disclosed hematuria, proteinuria, urinary casts, and elevated blood urea nitrogen and creatinine levels. The discussant reviews the differential diagnosis of acute renal failure in children.