Immediate percutaneous coronary intervention (PCI) is the treatment of choice for acute ST-segment elevation myocardial infarction. In this study, PCI that was "facilitated" by pretreatment with reteplase plus abciximab or abciximab alone did not improve clinical outcomes and increased bleeding, calling into question the use of facilitated PCI for the treatment of acute myocardial infarction.

Bivalirudin is a direct thrombin inhibitor. As compared with a combination of heparin and a glycoprotein IIb/IIIa inhibitor, bivalirudin use resulted in less bleeding and lower 30-day mortality among patients undergoing PCI for acute myocardial infarction. However, bivalirudin was associated with a higher rate of acute stent thrombosis within 24 hours.

A form of Leber's congenital amaurosis is caused by mutant RPE65, a critical component of the visual cycle. Two early clinical trials to assess subretinal injection of a viral vector containing RPE65 in young adults with advanced retinal degeneration show that this approach is generally safe in the short term, although one group reported an adverse event: macular hole. The authors observed improvement in some measures of visual function.

A form of Leber's congenital amaurosis is caused by mutant RPE65, a critical component of the visual cycle. Two early clinical trials to assess subretinal injection of a viral vector containing RPE65 in young adults with advanced retinal degeneration show that this approach is generally safe in the short term, although one group reported an adverse event: macular hole. The authors observed improvement in some measures of visual function.

The prevalence of smoking has decreased substantially in the United States over the past 30 years. This article examines the extent of person-to-person spread of smoking behavior and the extent to which groups of widely connected people quit together. Smoking behavior spreads through close and distant social ties, groups of interconnected people quit in concert, and smokers are increasingly marginalized socially.

A 28-year-old man presents with allergic rhinitis, primarily due to grass pollen, that has not previously responded to antihistamines and nasal sprays. A trial of sublingual immunotherapy is recommended. Sublingual immunotherapy is more convenient than injection immunotherapy. However, only one agent, which is specific for grass-pollen allergies, has been approved for clinical use in some European countries. The Food and Drug Administration has not approved any agent for sublingual immunotherapy.

A 46-year-old woman was evaluated at this hospital because of pain in the right hip and leg of several months' duration. The patient had a history of celiac disease but was otherwise well. Imaging studies disclosed multiple bone lesions in the pelvis and long bones, with a diffuse abnormality in the bone marrow. Laboratory tests showed low serum calcium and elevated alkaline phosphatase levels. A diagnostic procedure was performed.

The human immunodeficiency virus (HIV) binds an integrin receptor on CD4+ T cells in the gut.