In the Occluded Artery Trial (OAT), 2166 patients who had myocardial infarction with ST-segment elevation 3 to 28 days before enrollment and an occluded infarct-related coronary artery were randomly assigned to percutaneous coronary intervention (PCI) or medical therapy. At 4 years, the estimated rate of death, reinfarction, or class IV heart failure was 17.2% with PCI and 15.6% with medical therapy. These findings suggest that PCI should not be performed to open an occluded infarct-related artery after the currently accepted period for myocardial salvage has passed.

The constitutively active BCR-ABL tyrosine kinase is the cause of chronic myeloid leukemia. Imatinib is the first small synthetic molecular inhibitor of the BCR-ABL tyrosine kinase with clinical activity in chronic-phase myeloid leukemia. This 5-year follow-up of patients with the disease who began continuous treatment with imatinib reports that the drug can induce durable hematologic and cytogenetic responses in a high proportion of patients.

In this study, six patients received a diagnosis of antibiotic-associated hemorrhagic colitis and were negative for Clostridium difficile; five were positive for K. oxytoca. In a rat model, treatment with amoxicillin–clavulanate plus inoculation with K. oxytoca resulted in hemorrhagic colitis, showing that K. oxytoca can cause antibiotic-associated hemorrhagic colitis.

This double-blind, randomized, controlled trial evaluated rosiglitazone, metformin, and glyburide as an initial treatment in patients with type 2 diabetes. Rosiglitazone reduced the risk of treatment failure (the primary outcome) by 32% as compared with metformin and by 63% as compared with glyburide. The potential risks, benefits, and costs of these medications should all be considered to help inform the choice of pharmacotherapy for patients with type 2 diabetes.

A 44-year-old woman with chronic hepatitis C has intermittent fatigue and persistent elevations in serum alanine aminotransferase levels. Treatment with peginterferon and ribavirin is recommended. Combination therapy with these two agents can lead to sustained viral control and improvement in histologic features of the liver. Side effects of therapy and treatment failures are common.

The discovery of an identical mutation (V617F) of the JAK2 gene in patients with polycythemia vera, essential thrombocythemia, and myelofibrosis — the principal Philadelphia chromosome–negative myeloproliferative disorders — has greatly advanced our understanding of these conditions. This article reviews the legacy of this discovery and how it has changed our view of the origins, interrelations, and management of the myeloproliferative disorders.

A 36-year-old Pakistani woman presented to the emergency department with a 10-day history of a nonproductive cough, dyspnea, and fever. She reported no night sweats and no contact with anyone who was ill, including anyone with tuberculosis. She had been seen 1 week earlier at a walk-in clinic, where she received a prescription for moxifloxacin for presumed bronchitis, but her symptoms persisted.

Imatinib mesylate may affect particular signaling pathways that increase susceptibility to congestive heart failure.