Antiplatelet therapy with aspirin and a thienopyridine is a key component in the management of acute coronary syndromes. This trial compared a novel, potent thienopyridine (prasugrel) with the standard thienopyridine (clopidogrel) in patients with acute coronary syndromes scheduled to have a coronary intervention. Prasugrel led to better cardiovascular outcomes, but at the expense of more bleeding, including fatal bleeding.

Chitinases, a family of hydrolases, have been associated with animal models of asthma. In this cross-sectional study, circulating levels of YKL-40, a human chitinase-like protein, were examined in three cohorts of patients with asthma. Although there was overlap between controls and patients with asthma, on average, circulating YKL-40 levels were higher in patients with asthma, with the highest levels in the patients with the most severe disease.

This study compared teriparatide, an anabolic agent, with alendronate in an 18-month randomized, double-blind, controlled trial involving patients who had received glucocorticoids for at least 3 months and were at high risk for fracture. Bone mineral density increased more in patients receiving teriparatide than in those receiving alendronate, though increased calcium levels occurred more often in the teriparatide group. Teriparatide may prove to be useful in patients with glucocorticoid-induced osteoporosis.

This open-label trial of the treatment of colorectal cancer with cetuximab, a chimeric monoclonal antibody against the epidermal growth factor receptor (EGFR), showed that among patients with colorectal cancer that expressed EGFR and that had failed to respond to other treatments, overall survival and progression-free survival were better in those receiving cetuximab than in those receiving best supportive care alone.

This study of patenting by faculty members at academic medical centers documented a large increase in patent activity during the period from 1981 through 2000. Medical school faculty members were more likely to be patent holders if they had Ph.D. degrees and if they had received recent funding from the National Institutes of Health.

A previously healthy 45-year-old man presents with severe lower abdominal pain on the left side, which started 36 hours earlier. He has noticed mild discomfort in this region periodically before but has not sought medical treatment. He reports nausea, anorexia, and vomiting associated with any oral intake. On physical examination, his temperature is 38.5°C and his heart rate is 110 beats per minute. He has abdominal tenderness on the left side without peritoneal signs. How should his case be managed?

A 30-year-old Moroccan man with a history of inflammatory bowel disease was admitted to the hospital because of fever, abdominal pain, and bloody diarrhea. He had last traveled to Morocco 5 months before admission. On admission to the hospital, his temperature was 40.5°C and the heart rate was 70 beats per minute. There was atypical lymphocytosis in the blood, and serum levels of aminotransferases were slightly elevated. A diagnostic procedure was performed.