This report presents the outcomes for the first 1004 patients with AIDS who received combination antiretroviral therapy at a clinic in Port-au-Prince, Haiti. Despite high rates of poverty, malnutrition, and tuberculosis, the outcomes were similar to those in developed countries, providing evidence in support of international efforts to make antiretroviral treatment available to people with AIDS in developing countries.

Recently, the FDA issued an advisory stating that atypical antipsychotic medications (such as olanzapine and risperidone) increase mortality among elderly patients. This study compared mortality rates among elderly patients who began using either atypical antipsychotic agents or conventional drugs (such as perphenazine and thioridazine). Conventional agents were associated with a higher rate of death. Thus, elderly patients should not be switched from atypical to conventional agents to reduce the risk of death.

The authors measured mRNA for the T-cell marker FOXP3, as well as for CD25, CD3, perforin, and 18S ribosomal RNA in the urine of patients who had undergone renal transplantation, correlating results with biopsy findings and renal function. Only FOXP3 mRNA correlated inversely with serum creatinine levels in patients with acute rejection, thus providing a potentially noninvasive means of predicting outcome in acute rejection.

The authors report four deaths due to endometritis and toxic shock syndrome associated with C. sordellii that occurred within one week after abortions that were medically induced by administration of oral mifepristone and intravaginal misoprostol. Clinical findings included tachycardia, hypotension, edema, hemoconcentration, profound leukocytosis, and absence of fever.

A 38-year-old man notes abrupt loss of vision in his right visual field while reading. He has no significant medical history and reports that he does not smoke or use alcohol or illicit drugs. Physical examination reveals right homonymous hemianopia but no other abnormalities. MRI reveals acute left occipital infarction and normal head and neck vessels. Transesophageal echocardiography shows a patent foramen ovale without atrial septal aneurysm. What are the implications of this finding, and what therapy should be recommended?

This review considers the role of low-dose aspirin for the prevention of atherothrombosis, discussing the molecular mechanism of action of aspirin as well as clinical and epidemiologic studies of aspirin as an antiplatelet agent, with special emphasis on the benefits and risks in different patient populations.

An 80-year-old man presented for evaluation of shortness of breath and fatigue four weeks after repair of a hiatal hernia. He reported a mild, nonproductive cough and abdominal bloating. Before the surgery, he had been very active and had had no dyspnea.

Most HIV infections are spread by persons who do not know that they are infected. This article argues that it is time to adopt the proven strategies that have contained other epidemics: widespread voluntary screening, improved notification of the partners of infected persons, and case management with close monitoring. In the United States, this approach might have the potential to prevent at least half of all cases of HIV infection each year.