In this randomized trial in subjects between 15 and 65 years old, a new acellular pertussis vaccine was safe and had an efficacy of 92 percent against documented, symptomatic Bordetella pertussis infections. Among controls, the incidence of pertussis was 370 per 100,000 person-years. Vaccination of adults and adolescents could prevent pertussis and reduce the transmission of B. pertussis to young children.

Osteopontin, a matrix protein with a variety of functions, was identified in the malignant cells of pleural mesothelioma. Serum levels of osteopontin distinguished subjects with exposure to asbestos who did not have malignant disease from patients with exposure to asbestos who had pleural mesothelioma.

In this multicenter, randomized trial, neonates with moderate or severe hypoxic–ischemic encephalopathy randomly assigned to whole-body hypothermia had a significantly reduced risk of death or moderate or severe disability at 18 to 22 months of age. This study suggests that whole-body hypothermia may improve substantially the outcomes for infants with hypoxic–ischemic encephalopathy.

Antibodies against ganglionic acetylcholine receptors were detected in a patient with severe autonomic failure. Dramatic clinical improvement followed the removal of the antibodies by plasma exchange.

Malignant mesothelioma is an aggressive tumor of serosal surfaces, such as the pleura and the peritoneum. This tumor was once rare, but its incidence is increasing worldwide, probably as a result of widespread exposure to asbestos, a factor with which it is associated. The authors review advances made in the past 5 to 10 years in the understanding, diagnosis, and management of mesothelioma.

A 60-year-old man was evaluated at the hospital because of renal failure. He had been well until a trip to Colorado three months earlier; one week after returning he reported fatigue, edema, and a rash on his arms and legs. Laboratory evaluation revealed anemia, renal insufficiency, microscopic hematuria, and proteinuria. Serum complement levels were decreased. A skin biopsy showed leukocytoclastic vasculitis. Testing for cryoglobulins and antineutrophil cytoplasmic antibodies was negative. A diagnostic procedure was performed.

Dr. Elias Zerhouni, director of the National Institutes of Health, discusses translational and clinical research and presents a new plan to provide additional financial support for this important area of investigation.

A new candidate vaccine, designed to prevent infection by Mycobacterium tuberculosis, protects against a virulent and prevalent isolate in a mouse model.