The N Engl J Med image of the week shows CT scan coronal view of the abdomen with contrast material. We observe a hugely dilated bowel that I would interpret as bowel ischemia and mesenteric edema. We are given the clue of renal failure. The options are all antibodies: IgA anti-tissue transglutaminase, IgG antibodies against Lyme disease, Heliobacter pylori stool antigen, antimitochondial antibodies, and antineutrophil cytoplasmic antibodies. The first three clinical papers are an example of how to squeeze three papers out of a single clinical study. Hope-3 was a 2x2 multifactorial study of placebo, blood pressure reduction, LDL cholesterol reduction, or both together. The subjects were about 13,000 persons with “intermediate risk of cardiovascular disease (no prior events, but at least one major risk factor, namely elevated waist-to-hip ratio, history of low concentration of high-density lipoprotein cholesterol, current or recent tobacco use, dysglycemia, family history of premature coronary disease, and mild renal dysfunction). In the first study, we compare candesartan+hydrochlorothiazide, which lowered blood pressure about 6 mm Hg compared to placebo for 7 years. This blood pressure reduction did not decrease cardiovascular endpoint events, compared to placebo. In the next study, we compare rosuvestatin 10 mg to placebo. This strategy lowered LDL cholesterol by 25% and there were less events in the treatment group. The absolute reduction was 1.5%, at the expense of muscle symptoms. C-reactive protein made no difference. In the third study, both treatments together were compared to placebo. The first coprimary outcome was the composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke, and the second coprimary outcome additionally included heart failure, cardiac arrest, or revascularization. The combination of rosuvastatin (10 mg per day), candesartan (16 mg per day), and hydrochlorothiazide (12.5 mg per day) was associated with a significantly lower rate of cardiovascular events than dual placebo among persons at intermediate risk who did not have cardiovascular disease. However, the number-needed-to treat is about 60. These treatments are for the “worried” well. I believe what will come eventually is a “polypill” for the worried. Hemophilia A is congenital factor VIII deficiency. It is treated with either plasma-derived or recombinant factor VIII. With both treatments receiving injections about every-other-day, antibodies can develop resulting in “resistance”. Investigators conducted a randomized trial to assess the incidence of factor VIII inhibitors among patients treated with plasma-derived factor VIII containing von Willebrand factor or recombinant factor VIII. Patients treated with plasma-derived factor VIII containing von Willebrand factor had a lower incidence of inhibitors than those treated with recombinant factor VIII. It may be that the plasma-derived factor-VIII material has its epitopes covered by von Willebrand factor, thereby minimizing inhibiting antibody formation. In patients with severe hemophilia A, standard treatment is regular prophylactic and episodic intravenous infusions of factor VIII. However, these treatments are burdensome, especially for children, and may lead to the formation of anti–factor VIII alloantibodies (factor VIII inhibitors). Emicizumab (ACE910), a humanized bispecific antibody mimicking the cofactor function of factor VIII, was developed to abate these problems. The antibody bridges factor IX and factor X, thereby bypassing factor VIII. This novel strategy was a great success. Once-weekly subcutaneous administration of emicizumab markedly decreased the bleeding rate in patients who had hemophilia A with or without factor VIII inhibitors. The N Engl J Med review is on cryptogenic stroke. Cryptogenic ischemic strokes are symptomatic cerebral infarcts for which no probable cause is identified after adequate diagnostic evaluation. This problem involves about 25% of all stroke cases. The case of the week is a 31 year-old woman pregnant with twins who develops recurrent fever and signs of bacterial infection. This patient has Listeriosis, an infection well-known in pregnant women but quite unusual today. The varicocele patient from last week indeed had a left-sided renal cell carcinoma. In the Lancet, we learn that despite successful treatment of the culprit artery lesion by primary percutaneous coronary intervention (PCI) with stent implantation, thrombotic embolisation occurs in some cases, which impairs the prognosis of patients with ST-segment elevation myocardial infarction (STEMI). Invesitgators aimed to assess the clinical outcomes of deferred stent implantation versus standard PCI in patients with STEMI.