Determining an economically sustainable way to deliver the poliovirus vaccine remains a challenge and a priority. In this article, investigators in Oman show that with a one-fifth dose of the inactivated poliovirus vaccine given intradermally, the seroconversion rates at 7 months of age to all three poliovirus serotypes were equivalent to the rates with the standard full-dose vaccine given intramuscularly. However the median antibody titers were lower with the fractional dose than with the full dose.

Reversion of live attenuated oral poliovirus vaccine strains to a virulent phenotype is a rare but significant occurrence. In Nigeria, at least one vaccine-derived clone of type 2 poliovirus developed virulence, leading to ongoing transmission networks and many cases of paralysis. In this report, the characteristics of polio-associated disease and attack rates for this vaccine-derived clone are compared with circulating wild-type polioviruses 1 and 3. Increased vaccination efforts have significantly contributed to the control of all three serotypes. Implications for the global effort to eradicate polio are considered.

In this randomized trial involving patients with cirrhosis and acute variceal bleeding who were at high risk for treatment failure, control of bleeding was more common and mortality was lower among patients assigned to early treatment with a transjugular intrahepatic portosystemic shunt (TIPS) than among those assigned to standard treatment with rescue TIPS, if needed.

Previously untreated patients with non–small-cell lung cancer expressing mutated epidermal growth factor receptors (EGFRs) were randomly assigned to receive either the EGFR kinase inhibitor gefitinib or carboplatin plus paclitaxel. The gefitinib group had a significantly higher rate of complete response (73.7%, vs. 30.7% in the standard-chemotherapy group) and significantly longer survival (median, 30.5 months, vs. 23.6 months). Thus, defining the small subgroup of patients with EGFR mutations prospectively has important treatment implications.