This study examined two polymorphisms of the transcription factor 7–like 2 gene (TCF7L2) to predict the progression to diabetes among subjects with impaired glucose tolerance who were enrolled in the Diabetes Prevention Program, in which lifestyle intervention and treatment with metformin were each compared with placebo. Results indicate that common variants in TCF7L2 seem to be associated with an increased risk of the development of diabetes among persons with impaired glucose tolerance.

In a retrospective study of hospitalized patients, the prevalence of heart failure with preserved ejection fraction increased significantly between 1987 and 2001, as did the proportion of patients with preserved ejection fraction. The survival rate was slightly higher among patients with preserved than among those with reduced ejection fraction, but the prognosis improved over the 15-year period only among those with reduced ejection fraction.

Among 2802 patients hospitalized with heart failure, 31 percent had a preserved ejection fraction. These patients, as compared with those with reduced ejection fraction, were more likely to be older and female and to have a history of hypertension and atrial fibrillation. However, the presenting features, complications, readmission rates, and mortality rates were similar in the two groups.

This study shows that mutations in the neurogenin-3 gene are associated with a virtual absence of enteroendocrine cells and with malabsorptive diarrhea. Neurogenin-3 is critical to the differentiation of enteroendocrine cells, and the presence of these cells is required for absorption of nutrients by enterocytes.

In this study of research published in six prominent medical journals, the proportion of female first authors increased from 6 percent in 1970 to 29 percent in 2004 and the proportion of female senior authors increased from 4 percent to 19 percent. These increases have occurred during a period of dramatic growth in the number of female physicians — about 50 percent of medical students are now women, as compared with only 6 percent in 1960.

A 55-year-old man who had had an anterior-wall myocardial infarction six months previously and had a widened QRS complex on electrocardiography presents with refractory congestive heart failure despite medical therapy. Implantation of a biventricular pacemaker is recommended. The use of such pacemakers to resynchronize ventricular contraction has been demonstrated to prolong survival in certain subgroups of patients.

A 77-year-old man had difficulty walking that progressed rapidly during four months. For approximately 14 months, he had had a series of medical problems that prevented him from carrying out his usually brisk physical activities. On examination, motor strength and sensation were normal, and a neurologist noted mild hyperreflexia and bilateral Babinski signs. Despite physical therapy, his symptoms worsened and additional physical signs developed. A diagnostic procedure was performed.

Small-molecule inhibitors of Akt kinase are being developed as potential therapeutic agents for cancer. However, a recent study suggests that they may promote metastasis in certain settings.