In the Trial to Assess the Use of the Cypher Stent in Acute Myocardial Infarction Treated with Balloon Angioplasty (TYPHOON), patients with an acute myocardial infarction with ST-segment elevation underwent percutaneous coronary intervention with either a sirolimus-eluting stent or an uncoated stent. The use of the sirolimus-eluting stent was associated with significant reductions in the rate of target-vessel failure and the severity of in-stent late luminal loss.

The Paclitaxel-Eluting Stent versus Conventional Stent in Myocardial Infarction with ST-Segment Elevation (PASSION) trial compared the use of paclitaxel-eluting stents with uncoated stents for primary percutaneous coronary intervention in patients with acute myocardial infarction with ST-segment elevation. Although the paclitaxel-eluting stent was associated with a trend toward fewer serious adverse cardiac events, the trend was not significant.

Preoperative radiotherapy is standard in the treatment of rectal cancer. This study showed that the addition of fluorouracil-based chemotherapy to preoperative radiotherapy had no significant effect on the survival of patients with resectable rectal cancer. Chemotherapy, however, did improve local control of the cancer.

In this proof-of-concept study, fingolimod, an oral immunomodulating agent, reduced lesions detected on magnetic resonance imaging and the rate of clinical relapse among patients with relapsing multiple sclerosis. Adverse events associated with fingolimod included elevations in liver enzyme levels, a reduction in the heart rate, a decrease in forced expiratory flow, and one case of posterior reversible encephalopathy.

This study used data from Côte d'Ivoire to estimate cost-effectiveness of treatment strategies for adults infected with the human immunodeficiency virus. The incremental cost per year of life gained was $1,180 (2002 U.S. dollars) for trimethoprim–sulfamethoxazole prophylaxis and antiretroviral therapy with CD4 testing. The authors conclude that antiretroviral therapy is cost-effective in resource-poor settings.

A 62-year-old man has a bloodstream infection with a candida species other than Candida albicans. Caspofungin, an echinocandin antifungal agent, is recommended. The echinocandins are effective in treating candidemia in patients who do not have neutropenia. Their efficacy in the treatment of deep-tissue infections or in the setting of neutropenia has not been established.

A 59-year-old man was found to have bilateral renal masses. The right renal mass invaded the inferior vena cava. Fine-needle aspiration of the left renal mass disclosed renal-cell carcinoma. A right radical nephrectomy was performed. The optimal management of the left renal tumor is discussed.

A new secretion system in Vibrio cholerae, Pseudomonas aeruginosa, and other gram-negative bacteria represents a potential new target for vaccine development.