Tumor specimens from patients in a trial of cisplatin-based adjuvant chemotherapy for non–small-cell lung cancer were analyzed for the presence of ERCC1, an enzyme that participates in the repair of DNA damage caused by cisplatin. The absence of ERCC1 in the tumor was associated with a survival benefit from cisplatin-based adjuvant chemotherapy, whereas patients whose tumor expressed the enzyme failed to benefit from the chemotherapy.

This nested case–control study of healthy nulliparous women within the Calcium for Preeclampsia Prevention trial shows that the circulating level of soluble endoglin, an antiangiogenic protein, increased markedly 2 to 3 months before the onset of preeclampsia and was generally accompanied by decreased levels of placental growth factor and increased levels of circulating soluble fms-like tyrosine kinase 1. These studies set the stage for a prospective study to determine if measurement of these markers could provide means of identifying women at high risk for preeclampsia.

Unfractionated heparin has been the standard anticoagulant used during percutaneous coronary intervention (PCI). In this trial, adjusted-dose unfractionated heparin was compared with enoxaparin in patients undergoing PCI. Enoxaparin significantly reduced the rate of major bleeding. The effect on prevention of coronary events was not definitively assessed.

In a phase 1 trial, six healthy male volunteers received 0.1 mg per kilogram of body weight of a superagonistic anti-CD28 monoclonal antibody. Unexpectedly, all six volunteers had a transient critical illness characterized by multiorgan failure. These events give a view of a specific form of the cytokine-release syndrome in the absence of underlying medical disease.

A 28-year-old man reports feeling anxious and self-conscious around people in school, work, and social situations since his early teens. He appears shy and, on questioning, describes avoidance of speaking up in work meetings, attending social gatherings, and dating. He desperately wants to be more socially active but fears he will appear nervous and embarrass himself. How should he be evaluated and treated?

This review of oncogene-induced cell senescence describes a physiological mechanism that provides protection against cancer. The mechanisms underlying the arrest of growth in benign or premalignant neoplasms have considerable clinical implications.

A 61-year-old woman was hospitalized with a 2-day history of palpitations and dyspnea. She was found to be in atrial fibrillation with a rapid ventricular response, and intravenous diltiazem and a heparin infusion were begun. Her condition improved, but on the third hospital day, she reported feeling weak and nauseated and began passing dark red urine. She did not have a urinary catheter, palpitations, dyspnea, back pain, abdominal pain, dysuria, or dizziness.