Highlights

Drug-eluting stents

Drug-eluting stents are safer than bare-metal stents in the first year after insertion. However, rates of death and repeat revascularization appear to favour bare-metal stents in years 2 and 3. This is the finding of a 3-year follow-up study based on a large multicentre registry of all patients in the province of Alberta who were given drug-eluting or bare-metal stents during angioplasty. See Research, page 167

The long-term safety of drug-eluting stents, especially regarding late thrombosis, remains a concern, say Généreux and Mehran. See Commentary, page 154

Hospital at home

The “hospital-at-home” model, which is intended to avoid admission to hospital, was associated with a reduction in mortality at 6 months, greater satisfaction with care and lower costs. Shepperd and colleagues report this finding from their systematic review that included a meta-analysis of individual patient data. See Research, page 175

The hospital-at-home model could be one element in a portfolio of models for keeping certain patients with an acute illness out of hospital, says Leff. See Commentary, page 156

Safety of aprotinin

Aprotinin, which is used to minimize the loss of blood during cardiac surgery, may be associated with a moderate increase in the risk of death when compared to lysine analogues, according to a systematic review by Henry and colleagues. Based on these findings, the authors have modified the conclusion of their previous Cochrane review that was performed before a trial that raised concerns about the safety of aprotinin. See Research, page 183

Hepatitis B immunization

What is the optimal age for hepatitis B vaccination? Mackie and colleagues review the evidence for the effectiveness of vaccination programs for infants and adolescents. See Analysis, page 196

Neurofibromatosis

A 75-year-old man with long-standing neurofibromatosis and progressively decreasing vision in his right eye gives readers an opportunity to recall what they know about the condition first described by von Recklinghausen. See Practice, page 203

Chromaturia and discoloration of skin

A 54-year-old woman rescued from an apartment fire developed bright red discoloration of her skin and urine after being treated with hydroxocobalamin for cyanide poisoning. See Clinical images, page 251

European physicians crossing borders

Record numbers of European physicians are moving to other countries, raising concerns about patient safety and certification standards. See News, page 158