In a multicenter trial, 778 patients with septic shock who were being treated with catecholamine vasopressors were randomly assigned to either norepinephrine or vasopressin in addition to open-label vasopressors. There was no significant difference between the two groups in mortality at either 28 or 90 days, nor was there any significant difference in the rate of adverse events.

The World Health Organization guidelines for treating severe anemia in African children deal principally with malaria, folate deficiency, and iron deficiency. In this study of Malawian preschool children with severe anemia, deficiencies of folate and iron were infrequent, and multiple infectious agents in addition to malaria parasites were contributing causes.

In a genomewide association study of North Americans of European descent, followed by a Swedish replication analysis, investigators showed that in addition to the previously described loci at HLA-DRB1, IRF5, and STAT4, two new loci confer susceptibility to systemic lupus erythematosus. These loci are close to genes that encode B lymphoid tyrosine kinase and integrin alpha M.

Single-nucleotide polymorphisms (SNPs) in chromosomal regions 8q and 17q are associated with susceptibility to prostate cancer, although each SNP has only a modest association with the disease. This study identified five SNPs in these chromosomal regions that had a strong association with prostate cancer when combined. The strength of the association increased with the number of prostate-cancer–associated SNPs in the genome. The addition of a positive family history gave an even greater association. This study shows how weak associations between genetic variants and a disease that have been found in genomewide association studies can be strengthened through combinatorial analysis.

A newborn male infant is brought to the pediatrician's office with pronounced jaundice and a total serum bilirubin level of 19.5 mg per deciliter. Phototherapy is considered. In term and late-preterm infants, phototherapy is typically used according to guidelines that take into account the total serum bilirubin level, gestational age, postpartum age, and the presence or absence of specific risk factors.

Systemic lupus erythematosus has many guises, but the unifying feature is the presence of antibodies against double-stranded DNA in almost all patients. This review provides data that show that such autoantibodies cause the renal lesions of systemic lupus erythematosus, and it emphasizes the importance of histones, histone fragments, and other nuclear autoantigens.

A 17-year-old girl was transferred to this hospital because of chest pain and hemoptysis. A diagnosis of membranous glomerulonephritis with the nephrotic syndrome had been made 3 months earlier. The day before admission, she went to another hospital because of chest pain for 2 weeks, along with hemoptysis, fever, tachycardia, and tachypnea. Computed tomographic angiography showed emboli in both pulmonary arteries, and echocardiography showed acute right heart strain. The patient was transferred to this hospital, and a management decision was made.

Genetically corrected stem cells obtained from a mouse model of sickle cell anemia cure the mouse of disease.