In this trial involving patients with type 2 diabetes and stable ischemic cardiovascular disease, prompt revascularization was compared with medical therapy, and insulin sensitization was compared with insulin provision, with patients stratified according to whether they underwent percutaneous coronary intervention or coronary-artery bypass grafting. Revascularization did not significantly reduce the rate of death from any cause or the rate of major cardiovascular events overall. Insulin sensitization and insulin provision also had similar cardiovascular outcomes.

A current standard treatment for locally advanced prostate cancer is external-beam radiotherapy combined with 3 years of androgen suppression. Adverse events, such as myocardial infarction, are associated with long-term androgen suppression. This trial examined survival after treatment with long-term (3 years) or short-term (6 months) androgen suppression, plus external-beam radiotherapy, in men with locally advanced prostate cancer. Overall and prostate-cancer–specific survival in the group receiving short-term androgen suppression was inferior to that in the group receiving long-term suppression.

This large cohort study showed no significant association between the use of metoclopramide in pregnancy and risks of adverse outcomes for the fetus, including risks of major congenital malformations. These findings provide reassurance regarding the safety of metoclopramide for the treatment of nausea and vomiting in pregnancy.

Zika virus is a flavivirus known to cause human infection in Asia and Africa. This article describes an outbreak of Zika virus infection on Yap Island, Federated States of Micronesia, with predominant symptoms of rash, fever, arthralgia, and conjunctivitis. An estimated 73% of Yap residents 3 years of age or older became infected during the 4 months of the outbreak.

A genomewide association analysis of patients with primary biliary cirrhosis suggests that variation in interleukin-12 signaling may confer a risk of disease. This study also firmly implicates variants at the HLA locus as a risk factor.