Eltrombopag, an orally active agonist of the thrombopoietin receptor, elevates platelet counts in normal subjects and in patients with immune thrombocytopenia (see the article by Bussell et al. in this issue of the Journal). This preliminary trial tested the drug in patients with thrombocytopenia and cirrhosis associated with the hepatitis C virus. Eltrombopag was effective in raising the platelet count, thereby allowing for antiviral treatment for up to 12 weeks.

This trial tested the efficacy of eltrombopag, a small nonpeptide agonist of the thrombopoietin receptor, in patients with immune thrombocytopenia who had not had a response to at least one previous treatment for the disorder. At a dose of 50 or 75 mg, the agonist, which had been shown to increase platelet production in normal volunteers, increased platelet counts to a clinically safe level (50,000 per cubic millimeter) in most patients.

In this clinical trial, rosuvastatin was compared with placebo in elderly patients with systolic, ischemic heart failure. Although rosuvastatin significantly lowered levels of both low-density lipoprotein cholesterol and high-sensitivity C-reactive protein, it did not significantly reduce cardiovascular outcomes. However, it did reduce the number of hospitalizations. On the basis of these data, the role of statin therapy in heart failure appears to be limited.

The association between the presence of patent foramen ovale and stroke has not been established in older patients. In this prospective study, among patients 55 years of age or older, those with cryptogenic stroke (cause of stroke not identified before transesophageal echocardiography was performed) were more likely to have patent foramen ovale diagnosed on transesophageal echocardiography than were patients with stroke of known cause. This suggests that patent foramen ovale is a cause of stroke in older patients.

A 71-year-old man, whose wife died 6 months previously, presents with foot pain from diabetic neuropathy, poor sleep, lack of energy, and increasing frustration about his inability to "keep his diabetes under control." On examination, he also notes lack of interest, decreased appetite, a weight loss of 4.5 kg (10 lb) over the past 3 months, and intermittent thoughts that he would be better off dead. How should his case be managed?

The number of computed tomographic (CT) studies performed is increasing rapidly. Because CT scans involve much higher doses of radiation than plain films, we are seeing a marked increase in radiation exposure in the general population. Epidemiologic studies indicate that the radiation dose from even two or three CT scans results in a detectable increase in the risk of cancer, especially in children. This article summarizes the facts about this form of radiation exposure and the implications for public health.

A man was admitted 1 month after heart transplantation because of left ventricular dysfunction. Systemic amyloidosis with cardiomyopathy had been diagnosed 19 months earlier; cardiac function declined rapidly, and he underwent sequential cardiac and bone marrow transplantation. His cardiac function was then normal, and biopsy specimens showed no rejection. When an echocardiogram showed left ventricular dysfunction, a diagnostic procedure was performed.