Sirolimus-eluting stents and paclitaxel-eluting stents both reduce the risk of restenosis after percutaneous coronary intervention as compared with bare-metal stents. In a randomized trial, the two types of drug-eluting stents were compared in patients undergoing revascularization. The sirolimus-eluting stents were associated with fewer major adverse cardiac events at nine months, primarily as a result of reductions in the rates of clinical and angiographic restenosis.

Drug-eluting coronary-artery stents are more effective than bare-metal stents in reducing the frequency of coronary restenosis in patients with diabetes. In a randomized, controlled trial in patients with diabetes, the sirolimus-eluting stent was associated with a smaller extent of late luminal loss than was the paclitaxel-eluting stent, suggesting that the risk of restenosis was also reduced.

This study compared treatments and outcomes after myocardial infarction according to sex and race from 1994 through 2002. As compared with white men, black men and both white and black women had lower rates of reperfusion therapy and coronary angiography, and black women had higher mortality. Sex and racial differences did not change substantially between 1994 and 2002.

More than a decade ago, it was established that there were significant differences in the rates of major surgical procedures between blacks and whites. These investigators examined nine surgical procedures and found that the racial differences noted in 1992 persisted in 2001.

In this study examining trends from 1997 to 2003 for white patients and black patients enrolled in Medicare managed care, performance on all nine quality measures improved for both blacks and whites, and racial disparities narrowed for seven of the nine measures. These findings suggest that efforts to improve care for all patients result in reductions in racial disparities.

Soft-tissue sarcomas have traditionally been managed by wide excisional surgery and radiotherapy, with chemotherapy reserved for advanced disease. However, advances in multidisciplinary care have improved the evaluation and treatment of patients with this uncommon tumor. Limb-conserving surgery, superior radiotherapy delivery, and novel adjuvant agents for specific tumors are now available. This article reviews the current understanding and treatment of soft-tissue sarcoma, with an emphasis on recent advances.

A 40-year-old man was admitted to the hospital because of fever and weight loss of two months' duration. He had been well until an episode of gastroenteritis, after which daily fever, anorexia, and weight loss developed. A laparoscopic appendectomy was performed, but symptoms persisted. Repeated imaging showed occlusion of the portal vein.