In women with early breast cancer, adjuvant therapy with epirubicin plus the standard combination of cyclophosphamide, methotrexate, and fluorouracil (CMF) was shown to improve both relapse-free and overall survival, as compared with the standard CMF regimen alone.

In a large, national program of colorectal-cancer screening in Poland, men were about twice as likely as women to have advanced neoplasia detected on colonoscopy. The yield of colonoscopy among men 40 to 49 years of age was similar to that among women 55 to 59 years of age (in these differing age groups, one advanced neoplasia detected for every 23 men and 22 women screened).

Fifteen patients with severe heart failure underwent implantation of left ventricular assist devices followed by a specific pharmacologic regimen. Eleven patients had sufficient myocardial recovery to permit explantation of the device, and eight of these patients were alive and free of heart failure or transplantation more than 4 years later.

Maternal periodontal disease has been associated with an increased risk of preterm birth and low birth weight. In this randomized trial, nonsurgical treatment of periodontitis (including scaling and root planing) in pregnant women improved periodontal disease but did not significantly alter rates of preterm birth, low birth weight, or fetal growth restriction.

More than half the commercial health maintenance organizations (HMOs) in this national survey were found to use pay for performance in their provider contracts. This situation affects more than 80% of all those enrolled in the HMOs surveyed. These data are important and informative, because Medicare is moving closer to adopting pay for performance for physicians, health plans, and other institutions.

A 53-year-old woman with asthma and multilobar pneumonia is admitted with respiratory failure. She is intubated and treated with antibiotics, albuterol, and methylprednisolone. A random blood glucose measurement obtained on admission shows a level of 183 mg per deciliter (10.2 mmol per liter). After 3 hours in the intensive care unit, she has a capillary glucose level of 264 mg per deciliter (14.7 mmol per liter). She has no history of diabetes. Should her hyperglycemia be treated, and if so, how?

A 21-year-old man presented to the emergency department after 2 days of pain in the right lower abdominal quadrant. The pain was dull and nonradiating, and it had increased in intensity during those 2 days. It was not worsened by food intake and was unrelated to bowel movements. He also noted that for the past month he had had exertional dyspnea with a cough productive of scanty yellow sputum.

Potential voters rated the importance of health care issues in the upcoming congressional elections below that of the economy, the Iraq war, and terrorism. They identified lack of insurance coverage and health care costs as the most important health care issues. The authors report that although Americans are concerned about the state of the health care system, health care issues are not likely to be a major factor in the 2006 elections.