It is well known that among patients with cystic fibrosis who have the F508 deletion mutation, there is substantial variation in the severity of clinical disease. These investigators identified, and then replicated in a second population, variants in the DNA encoding of the TGF1 gene that were associated with more severe disease.

Do higher fasting plasma glucose levels within the normal range independently predict the risk of type 2 diabetes? This study revealed a progressively increased risk of incident diabetes with fasting plasma glucose levels at the high end of the normal range. Fasting glucose levels, when considered together with body-mass index and triglyceride levels, may help to identify apparently healthy young men at increased risk for diabetes.

An outbreak of gastroenteritis on a cruise ship led to the identification of 62 people with diarrhea due to V. parahaemolyticus after consumption of raw Alaskan oysters. The source of the oysters was 1000 km farther north than the source for any previous outbreak. Rising ocean temperatures seem to have contributed to this outbreak.

Eight clinical trials have evaluated the benefit of the implantable cardioverter–defibrillator (ICD) in patients with left ventricular dysfunction but no previous life-threatening ventricular arrhythmia. The cost-effectiveness of the ICD in this setting was investigated with the use of a Markov model that incorporated data from these trials. Prophylactic implantation of an ICD was estimated to have a cost-effectiveness ratio below $100,000 per quality-adjusted life-year gained.

A 17-year-old girl is taken to her physician by worried parents. Never overweight, in the past six months she became determined to reduce from her baseline weight of 59.1 kg. Her height is 1.7 m; body-mass index, 21. Through dieting and exercise, she lost 13.6 kg and stopped menstruating four months ago; her current body-mass index is 16. She denies having any problems and is annoyed that her parents, friends, and teachers are concerned. How should she be evaluated and treated?

This review discusses the structure and function of molecular chaperones, with emphasis on their role in rescuing misfolded proteins. It also includes a discussion of the diseases in which abnormalities of these caretaker molecules or their molecular partners have been found.

A 50-year-old man presented to the clinic with fever, chills, and generalized weakness that he had had for three weeks. He also noticed pain and swelling in his right hand and left elbow, a weight loss of about 4.5 kg, and occasional upper abdominal pressure. He had no nausea, vomiting, diarrhea, dyspnea, or dysuria.

In this article, the authors discuss the obstacles to the use of cost-effectiveness analysis in Medicare decisions about coverage. They argue that policymakers could avert the impending financial crisis facing Medicare by incorporating cost-effectiveness analysis into a comprehensive strategy to allocate health care resources more rationally.