Patients in four randomized trials comparing sirolimus-eluting coronary-artery stents and bare-metal stents were included in a pooled analysis. At 4 years, there were no significant differences in the rates of death, myocardial infarction, or stent thrombosis between the two groups. A subgroup analysis suggested that mortality was higher among patients with diabetes receiving a sirolimus-eluting stent than among those receiving a bare-metal stent.

A pooled analysis was performed comparing drug-eluting stents with bare-metal stents in terms of safety and efficacy, using data from four sirolimus-stent trials and five paclitaxel-stent trials. Between 1 and 4 years, stent thrombosis occurred more frequently with both drug-eluting stents. There were no differences between either drug-eluting stent and the bare-metal stent in rates of death or myocardial infarction.

In this large Swedish study of patients with coronary angioplasty, drug-eluting stents were associated with a higher rate of death than bare-metal stents. The higher death rate (and composite of death and myocardial infarction) became apparent after 6 months. The authors suggest that these findings, which might have been related to the discontinuation of clopidogrel therapy, raise uncertainty about the long-term safety of drug-eluting stents.

Stent thrombosis is a serious complication of treatment with coronary stents. In an analysis using data readjudicated according to criteria set by the Academic Research Consortium, the authors found no increased risk of stent thrombosis with either sirolimus-eluting stents or paclitaxel-eluting stents, as compared with bare-metal stents. However, the power to detect small differences in the risk of stent thrombosis was limited.

Sirolimus-eluting coronary-artery stents were compared with bare-metal stents in a pooled analysis of 14 randomized trials. There were no significant differences in the rates of death or myocardial infarction. The early reduction in target-lesion revascularization with the sirolimus-eluting stent was sustained. Rates of stent thrombosis with the sirolimus-eluting stent were at least as high as those with bare-metal stents.

A healthy 3-year-old boy presents with a 6-month history of strabismus in his left eye. The visible inward deviation of the eye began intermittently but is now constant. His visual acuity is 20/20 in the right eye but only 20/100 in the left eye. The physical examination is otherwise normal. How should he be treated?

A 59-year-old woman with diabetic renal disease was admitted to the hospital because of nonhealing painful ulcers on the right leg and foot. An ulcer on the heel had developed 6 years earlier and persisted despite local treatment, with development of osteomyelitis refractory to antibiotic therapy. A few months before admission, new painful ulcers developed on the right hip and thigh. A procedure was performed.

Given the shortage of transplantable organs, some potential recipients are going to great lengths to find organ donors on their own. This article reviews the medical, ethical, and public policy issues involved in solicitation, and it suggests possible solutions.