More than 9000 women were followed for a median of 15 years after a diagnosis of benign breast disease. As compared with women in a SEER database, they had an increased risk of subsequent breast cancer, especially if the benign lesion showed signs of atypia. A family history of breast cancer and younger age at diagnosis also increased the risk. Cancers developed in either breast, but an excess number occurred in the same breast.

Statins reduce cardiovascular events in persons with type 2 diabetes mellitus. This study randomly assigned patients with type 2 diabetes receiving hemodialysis to receive 20 mg of atorvastatin per day or matching placebo. Atorvastatin reduced all cardiac events combined but not all cerebrovascular events combined or total mortality.

This report describes six patients who had postprandial symptoms of neuroglycopenia from endogenous hyperinsulinemic hypoglycemia after Roux-en-Y gastric bypass surgery. Hypoglycemic symptoms diminished in all patients after partial pancreatectomy. The authors speculate that hyperfunction of pancreatic islets did not lead to obesity but rather that beta-cell trophic factors may have increased as a result of gastric bypass.

In 2002, the JCAHO began requiring hospitals to report their performance on standardized measures of the quality of health care and began providing hospitals with feedback on their performance. This study documented substantial improvement between 2002 and 2004 in hospitals' performance for myocardial infarction, congestive heart failure, and pneumonia. Hospitals with a low level of performance at baseline had the largest improvements.

This study examined hospitals' performance on standardized measures of the quality of care for acute myocardial infarction, congestive heart failure, and pneumonia. The quality of care varied among hospitals. Hospitals' performance on the measures for myocardial infarction and congestive heart failure was not closely correlated with performance on the pneumonia measure, suggesting that efforts to monitor the quality of care may need to include a wide range of medical conditions.

About 50 percent of women have histologic evidence of some degree of fibrocystic changes in the breast. This review article describes the spectrum of benign breast disorders, including those that increase the risk of malignant disease. The authors explain the evaluation and management of breast pain, breast discharge, and focal lesions, as well as the options that can prevent progression to breast cancer.

An 81-year-old man was admitted to the hospital because he had had cough and fever for two weeks and had recently become confused. He had had chronic lymphocytic leukemia for six years. His mental status continued to deteriorate, with coma and respiratory arrest, and he died on the 12th hospital day.

A chimeric fusion protein inhibits the allergic reaction induced by cat allergen in a mouse model.