Amyloid A (AA) amyloidosis, a complication of chronic inflammatory conditions, develops when proteolytic fragments of serum amyloid A protein are deposited in tissues as amyloid fibrils. This placebo-controlled trial investigated the effect of eprodisate, a small molecule that inhibits amyloid fibril polymerization and tissue deposition in patients with renal AA amyloidosis. As compared with placebo, the drug slowed a decline in renal function. Eprodisate is a member of a new class of compounds that interfere with interactions between amyloidogenic proteins and glycosaminoglycans.

This study evaluated clinical features, organ function, and survival in a group of 374 patients with amyloid A amyloidosis. Median survival after diagnosis was 133 months; renal dysfunction was the predominant disease manifestation. Mortality, amyloid burden, and renal prognosis all significantly correlated with the serum amyloid A concentration during follow-up.

This retrospective analysis assessed the efficacy of adjuvant mitotane treatment in prolonging recurrence-free survival in adrenocortical cancer, which carries a high risk of recurrence. Survival was significantly prolonged in patients receiving mitotane, as compared with those who did not. Adjuvant mitotane may prolong recurrence-free survival in patients with radically resected adrenocortical carcinoma.

A 43-year-old woman returned from a trip to Peru and had fever, rash, and splenomegaly. A new bartonella species has been identified as the causative agent.

Mortality due to coronary heart disease has declined substantially in the United States in recent decades. A previously validated model was used to estimate the roles of specific cardiac treatments and changes in risk factors in this decline. Approximately 47% of the decrease in mortality was attributed to therapeutic interventions and 44% to changes in risk factors.

Some investigators have viewed breast cancer as a local disease that then spreads; others have seen it as a systemic disease from the start. This review argues for another view, since the failure to achieve initial local control allows some tumors to disseminate later, reducing a patient's chance of long-term survival. Recent evidence supports a larger role for aggressive, local therapy for breast cancer.

A 34-year-old black woman presented to a walk-in clinic with a 3-day history of malaise. Her colleagues had noticed yellowing of her eyes over the past few days.

The integrity of the synovium depends on the adhesion molecule cadherin-11. Mice that are deficient in this molecule are resistant to induced inflammatory arthritis.